Patient Transition Coordinator

Position Summary

The Patient Transition Coordinator supports seamless care transitions by coordinating referrals to hospice, home health, home infusion, and palliative services. Works closely with Care Transition Coordinators and Home Health Care Transition Coordinators to ensure patients receive timely and appropriate services.

• Organizes, tracks, and builds a complete medical record for appropriate patient transition to home health providers, and confirms start of care (SOC) for each patient referred.
• Identifies all post‑acute care needs and collaborates with the Care Transition Coordinator.
• Collaborates with all Compassus/Ascension at Home intake teams.
• Completes the transition of care, including submission of complete referral and securing outside agency placement if Compassus/Ascension at Home is unable to service the patient.
• Organizes and prioritizes large volumes of information.
• Displays exceptional customer service to patients, families, and referral sources.
• Handles confidential and non‑routine information.
• Manages and creates general correspondences, memos, charts, tables, graphs, business plans, etc.
• Utilizes computer software applications (MS Word, Excel, Access, PowerPoint).
• Performs other duties as assigned.

• Licensed Practical Nurse preferred.
• Bachelor’s degree in a health‑related field preferred.
• Minimum of one year of experience in a related health care setting preferred; one year in home health, hospice and/or palliative preferred.
• Prior experience with electronic medical records preferred.
• Knowledge of home health, hospice, and palliative eligibility requirements preferred.
• Mathematical skills: addition, subtraction, multiplication, division, rates, ratios, and percentages.
• Language skills: read, analyze, and interpret business periodicals, professional journals, technical procedures, or governmental regulations; write reports and business correspondence; present information effectively.
• Strong written and verbal communication.
• English proficiency.

Regular standing, walking, manual dexterity, ability to lift up to 25 pounds. Visual acuity requirements: close and distance vision, color and peripheral vision, depth perception, and ability to adjust focus.

As an equal opportunity employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.