Transitional Care Coordinator – Home Health

Black Women's Mental Health Institute; Oak Lawn (IL); On-site; USD 45,000 - 65,000; Full time

Job summary

Black Women's Mental Health Institute is seeking a Transitional Care Navigator to support patients and families through care transitions from hospital or facility to home and community-based services. You will coordinate discharge plans, connect clients with home health, personal care, or hospice, and work with interdisciplinary teams to ensure safe, timely transitions.

The role emphasizes patient education, advocacy, and preserving dignity and independence, with a focus on compassionate,

Qualifications

• Strong communication and interpersonal skills.
• Ability to coordinate multiple care activities effectively.
• Patient-centered approach with empathy and advocacy skills.
• Experience or knowledge in healthcare services, care planning, or case management is preferred.

Responsibilities

• Support patients and families during care transitions from hospital or facility to home or community-based services.
• Coordinate discharge plans and schedule follow-up appointments.
• Connect clients with personal care, home health, or hospice services to ensure safe, timely transitions and reduce readmissions.
• Collaborate with interdisciplinary teams to deliver comprehensive care.
• Educate patients on care plans and available resources.
• Advocate for patient dignity, respect, and independence.

Skills

Strong communication

Coordinate multiple care activities

Patient-centered approach

Healthcare services knowledge

Job description

• Support patients and families during care transitions from hospital or facility to home or community-based services.
• Connect clients with personal care, home health, or hospice services to ensure safe, timely transitions and reduce readmissions.
• Collaborate with interdisciplinary teams to deliver comprehensive care.
• Educate patients on care plans and available resources.
• Advocate for patient dignity, respect, and independence.

Role: Transitional Care Navigator

Responsibilities

• Support patients and families during care transitions from hospital or facility to home or community-based services.
• Coordinate discharge plans and schedule follow-up appointments.
• Connect clients with personal care, home health, or hospice services to ensure safe, timely transitions and reduce readmissions.
• Collaborate with interdisciplinary teams to deliver comprehensive care.
• Educate patients on care plans and available resources.
• Advocate for patient dignity, respect, and independence.

Qualifications And Skills

• Strong communication and interpersonal skills.
• Ability to coordinate multiple care activities effectively.
• Patient-centered approach with empathy and advocacy skills.
• Experience or knowledge in healthcare services, care planning, or case management is preferred.