Post Acute Care Coordinator

Post Acute Care Coordinator Job Title: Coordinator Clinical. Location: SBC Corporation. Department: ACO. Position: Full-time, day shift. Pay Range: $57,000 – $90,000 per year. Facility: RWJBarnabas Health Corporate Services, 95 Old Short Hills Road, West Orange, NJ. Job Overview As part of the RWJ Barnabas Health Population Health team, the Post‑Acute Care Coordinator works within the multidisciplinary team to improve care for patients in value‑based, ACO, and bundled payment programs. The coordinator evaluates treatment plans and goals at post‑acute facilities, partners with clinical teams to progress toward discharge goals, and coordinates next site of care and follow‑up with providers and community services. Essential Functions Performs initial and ongoing assessments of patient condition during and after a post‑acute episode. Establishes, revises, and evaluates a plan of care appropriate to identified problems and involves the patient/family. Participates in multidisciplinary rounds with the clinical team to create a collaborative care plan that is patient‑ and family centered, follows evidence‑based guidelines, and promotes the best outcome for the patient. Provides continuity of care by participating in discharge planning with post‑acute facilities and other health care providers, including giving home instructions, recommending equipment or home modifications, and arranging appropriate follow‑up care. Provides education to staff by assessing the patient/family educational needs. Maintains appropriate documentation detailing patient response to therapy and the need for skilled intervention as outlined by regulatory bodies. Provides resources and education to post‑acute facilities on readmissions. Serves as a resource for post‑acute facilities. Qualifications Required 3–5 years’ experience managing relationships between acute and post‑acute facilities. Previous work experience in a post‑acute care setting. Ability to travel to post‑acute and hospital sites throughout New Jersey. Strong organizational skills with the ability to prioritize multiple tasks and deadlines. Strong leadership skills to achieve buy‑in and collaboration toward objectives. Preferred Knowledge of various value‑based programs. Licenses Required NJ LPN – Certificate NJ RN – Associates NJ Physical Therapy – Certificate NJ Occupational Therapy – Certificate NJ Respiratory Therapy – Certificate NJ LSW – Associates Scheduling Requirements Monday to Friday, full time 9:00 AM – 5:00 PM. Weekly travel throughout New Jersey. Benefits Paid Time Off Medical and Prescription Drug Insurance Dental and Vision Insurance Retirement Plans Short & Long Term Disability Life & Accidental Death Insurance Tuition Reimbursement Health Care / Dependent Care Flexible Spending Accounts Wellness Programs Voluntary Benefits (e.g., Pet Insurance) Discounts through partners such as NJ Devils, NJ PAC, Verizon, and more Equal Opportunity Employer RWJBarnabas Health is an Equal Opportunity Employer. #J-18808-Ljbffr