Onsite Geriatric Care Transition Specialist

Optum; La Porte (IN); Hybrid; USD 46,838 - 84,033; Full time

Benefits offered by this job

Comprehensive benefits

Equity stock purchase

401(k) contribution

Incentive programs

Job summary

Optum Home & Community Care, part of UnitedHealth Group, seeks a Care Coordinator–Onsite to support older adults transitioning from hospital to home. This hybrid role requires four in‑office days per week and focuses on coordinating SNF assessments, discharge planning, and collaboration with the care team to keep patients in the community.

You will work with physicians, nurses, social workers, and other providers, reviewing CMS criteria, ensuring timely authorizations, and guiding families

Qualifications

• Active, unrestricted clinical license in the state of hire (RN, PT, OT, or SLP).
• At least 5 years of clinical experience.
• Ability to support on-site facility needs within a 30‑mile radius of home location.

Responsibilities

• Serve as the link between patients, families and health-care personnel to ensure smooth transitions of care.
• Perform SNF assessments using CMS criteria upon admission and during stay.
• Review discharge plans with providers and families and update authorizations promptly.
• Collaborate with the care team to establish an optimal discharge plan.
• Ensure progress toward discharge goals and resolve barriers.
• Participate in SNF rounds and communicate with leadership.
• Maintain HIPAA privacy and compliance.

Skills

Clinical license

Experience

Driver's license

On-site/local travel

Job description

Optum Home & Community Care, part of UnitedHealth Group, seeks a Care Coordinator–Onsite to support older adults transitioning from hospital to home. This hybrid role requires four in‑office days per week and focuses on coordinating SNF assessments, discharge planning, and collaboration with the care team to keep patients in the community.

You will work with physicians, nurses, social workers, and other providers, reviewing CMS criteria, ensuring timely authorizations, and guiding families