Transitional Care Liaison-Home Health

Luxe Home Health LLC•Merrillville, IN

3d•$60,000 - $65,000•Remote

About The Position

Luxe Home Health is a leading provider of home health care services, dedicated to offering high-quality care with compassion and respect. We are currently seeking a compassionate, detail-oriented, and experienced Transitional Care Liaison to join our growing team in the greater Northwest Indiana area. If you are passionate about supporting long-term care patients and their families, we want to hear from you! As a Transitional Care Liaison at Luxe Home Health, you will play a key role in ensuring smooth transitions for patients moving from nursing home settings to home care. This position requires a strong background in discharge planning, social work, and long-term care, as you will coordinate care between patients, families, and healthcare teams to provide comprehensive support.

Requirements

1-2 years of social work experience, ideally in a nursing home or long-term care setting.
Discharge planning experience is highly preferred.
Valid IN Driver’s License: Must have a valid driver’s license, reliable transportation, and the ability to travel within the greater Northwest Indiana service area.
Excellent verbal and written communication skills.
Strong proficiency in electronic health record (EHR) systems and other relevant computer software, including Microsoft excel, and data tracking.
Ability to work independently, as well as collaboratively, in a fast-paced team environment.
Empathetic and patient-focused, with strong problem-solving skills.
Knowledge of community resources and services available for long-term care patients.

Nice To Haves

Discharge planning experience is highly preferred.

Responsibilities

Act as the primary liaison between nursing homes, patients, families, and home health care teams to ensure seamless care transitions.
Ensure all patient needs are addressed and that resources are in place for a successful transition from nursing homes to home care.
Provide counseling and support to patients and families, addressing emotional, social, and practical challenges related to long-term care and discharge planning.
Maintain strong communication with multidisciplinary teams, including physicians, nurses, case managers, and other healthcare professionals.
Accurately document assessments, care plans, and interventions in electronic health record (EHR) systems.
Identify and connect patients and families with appropriate community resources and support services.
Advocate for patients, ensuring their rights, preferences, and needs are respected throughout the care process.
Ensure compliance with relevant regulations and professional standards in social work practice.