Remote Post-Acute Transitions Navigator (RN/LSW)

CareSource; United States; Remote; USD 63,000 - 100,000; Full time

Job summary

CareSource in Ohio is seeking a Transitions Coordinator - Post Acute-4 to monitor and manage member care transitions between long-term care, respite facilities, and HCBS waivers, through clinical review and benefits management.

The role partners with care coordination staff and other stakeholders to ensure timely, compliant services and cost-effective discharge planning within an interdisciplinary team.

Qualifications

• RN degree program completion or Ohio social work licensure required.
• BSN or healthcare-related degree preferred.
• Three years in case management or managed care required.
• Medicare/Medicaid managed care experience preferred.
• Post-acute/home care/waiver/acute clinical care experience preferred.

Responsibilities

• Acts as a primary ICT point of contact to support level of care transitions.
• Ensures timely NF level of care completions and HCBS waiver enrollment changes.
• Verifies eligibility and enrollment history during case reviews.
• Monitors benefit eligibility throughout transitions and reviews.
• Coordinates with care coordinators, waiver staff, and providers for discharge planning.
• Maintains clinical documentation in the EMR per guidelines.
• Escalates care needs to leadership and supports compliance activities.

Skills

Microsoft Office

Windows OS

Mobile devices

Written communication

Teamwork

Time management

Medicare knowledge

Education

RN licensure in Ohio

BSN preferred

LSW/LISW licensure

Job description

CareSource in Ohio is seeking a Transitions Coordinator - Post Acute-4 to monitor and manage member care transitions between long-term care, respite facilities, and HCBS waivers, through clinical review and benefits management.

The role partners with care coordination staff and other stakeholders to ensure timely, compliant services and cost-effective discharge planning within an interdisciplinary team.