Care Transition Associate

Compassus•Indianapolis, IN

4d•Remote

About The Position

The Weekend Care Transition Associate provides non-clinical administrative and care coordination support within acute care hospital hubs for patients who need home health or hospice services. The role supports patients, families, hospital care teams, Care Partners, Clinical Care Partners, and post-acute care providers with referrals, discharge arrangements, and coordination of services needed for a timely start of care. The position also helps maintain referral-source relationships and participates in educational outreach and other care coordination activities. This is a remote role, and the team member must reside in the Eastern Time Zone. Coverage is required on Saturdays and Sundays, with a schedule of 8:00 a.m. to 6:00 p.m. The role requires strong communication, organization, customer service, problem-solving, documentation, and computer skills, along with knowledge of home health and hospice coordination processes.

Requirements

Associate’s degree or equivalent education and experience. A high school diploma or equivalent plus three years of work experience is considered equivalent to an Associate’s degree.
At least one year of experience working with patients and families and providing customer service and administrative support, preferably in a healthcare setting.
Strong written and verbal communication skills and the ability to communicate professionally and sensitively with patients, families, healthcare professionals, and external stakeholders.
Ability to develop collaborative working relationships and provide effective customer service.
Strong organizational and problem-solving skills, including the ability to manage competing priorities, adapt to change, remain calm under pressure, and maintain attention to detail.
Understanding of home health and hospice care coordination, Value-Based Enterprise agreements, referral processes, payer criteria, and community resources.
Proficiency with electronic medical records, standard computer applications, and office equipment.
Ability to maintain accurate documentation and perform basic arithmetic, including calculations involving rates, ratios, and percentages.
Ability to perform the role’s physical functions, including regular standing, walking, manual dexterity, and lifting or moving objects up to 25 pounds.
Must reside in the Eastern Time Zone.
No certifications, licenses, or registrations are required.

Nice To Haves

Two or more years of relevant healthcare experience.
Healthcare-related coursework or training, including medical terminology.
Proficiency in Microsoft Word and Excel.
Experience with Epic or other electronic medical record systems.
Medical terminology knowledge.

Responsibilities

Serve as a non-clinical liaison between inpatient and outpatient settings, supporting Care Partners, Clinical Care Partners, and hospital care teams with home health and hospice referrals and discharge arrangements.
Coordinate referral and admission activities, including collecting and verifying patient demographic, insurance, medical, and other relevant information; obtaining required orders and documentation; and assisting with scheduling starts of care.
Gather and organize information to support clinical assessment of patient appropriateness for home health and hospice services.
Collaborate with clinical team members to coordinate services and equipment consistent with applicable orders, admission criteria, and patient needs.
Communicate with physicians, provider offices, hospital discharge planners, and referral sources to verify orders, identify following providers, obtain information, and address barriers to timely discharge and start of care.
Provide administrative support to Care Partners and Clinical Care Partners, including electronic medical record documentation, chart organization, referral and reimbursement coordination, and information distribution.
Provide patients and families with information and educational materials about home health and hospice services, verify pertinent information, and coordinate equipment delivery with vendors.
Maintain knowledge of community resources, payer criteria, managed care contracts, network provider arrangements, and durable medical equipment resources.
Build and maintain positive relationships with hospital care teams, physician groups, referral sources, and post-acute care providers.
Support educational outreach, service updates, meetings, reporting, and training activities as assigned.
Monitor care arrangements, follow up on outstanding needs, and resolve customer service concerns within the scope of the role.
Escalate clinical concerns, changes in patient condition, and other issues to appropriate team members or leadership.
Follow applicable policies, procedures, and regulatory requirements, including HIPAA, confidentiality, infection control, safety, and disaster preparedness.
Participate in required training and perform other duties as assigned.