Transitions Coordinator – Post Acute

🔥 3 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $62.7k - $100.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 21 days.

Apply Now

Find Similar Remote Jobs

CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Monitor and manage member level-of-care transitions to and from long-term care, respite nursing facility services, and HCBS waiver services • Manage enrollment and disenrollment of home and community-based waiver services through clinical review and benefits management • Partner with care coordination, waiver service coordination staff, and other stakeholders as part of the interdisciplinary care team • Complete nursing-facility level-of-care reviews, respite request reviews, and waiver enrollment/disenrollment processes • Verify member eligibility, enrollment history, and demographics • Monitor and assist members in maintaining benefit eligibility during transitions • Coordinate and document clinical reviews and requested services in the clinical documentation system • Support appeals processes and gather clinical documentation • Coordinate discharge planning and safe transitions between levels of care • Review medical records, contacts, treatment plans, case notes, referrals, and assessments for compliance and accreditation • Assist with care plan development and implementation • Attend interdisciplinary team meetings, State Hearings, and Medical Advisement meetings when requested • Escalate care coordination needs and refer quality issues to Quality Improvement • Maintain knowledge of federal and state regulations, CareSource contracts, provider agreements, and Medicare/Medicaid benefits • Precept and mentor new staff • Participate in special projects or research • Maintain required reporting and assist with data analysis

🎯 Requirements

• Completion of an accredited Registered Nurse (RN) degree program or degree required to obtain Social Worker licensure in the State of Ohio • Current, unrestricted Registered Nurse (RN), Licensed Social Worker (LSW), or Licensed Independent Social Worker (LISW) licensure in the State of Ohio • Three (3) years of experience in case management and/or managed care • Intermediate proficiency in Microsoft Office Suite • Basic knowledge of a Windows-based environment • Ability to operate a smartphone, iPad, or other mobile communication devices • Excellent written and verbal communication skills • Ability to work with diverse populations in a non-judgmental manner • Ability to work independently and within a team • Strong organizational skills • Excellent assessment skills • Attention to detail • Knowledge of Medicare and Medicaid • Critical thinking and listening skills • Time management skills • Customer service orientation • Decision-making and problem-solving skills • Knowledge of evidence-based medical criteria and/or standards of care

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • In-person meeting attendance may be required • Travel is not typically required

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume