Access & Transitions Coordinator

Access & Transitions Coordinator

Location: Fort Wayne, Indiana
Hourly Rate: $24 - $28
Type: Full-Time (8-hour workday with 8a-5p timeframe, with flexibility based on operations needs)

Job Summary : The Access and Transitions Coordinator is responsible for coordinating and managing all aspects of participant access to services, including community inquiries, resource navigation, intake, enrollment, and transitions across the agency. This role serves as the primary entry point for referrals and service inquiries and acts as the central coordinator connecting internal programs, external partners, and participants and their support teams to ensure timely access to services. Working with a high level of autonomy, the Access and Transitions Coordinator oversees referral pipelines, facilitates intake and transition processes, provides guidance on available services and resources, and ensures timely, compliant, and person-centered service delivery. This role requires strong organizational oversight, proactive communication, and the ability to manage multiple processes simultaneously while identifying barriers to service access and supporting continuity of care across departments.

Key Responsibilities:

1. Referral Management, Intake Coordination & Enrollment

• Serve as the primary point of contact for incoming referrals, community inquiries, and service requests
• Respond to and triage referrals in a timely manner, ensuring appropriate follow-up and connection to services
• Lead and manage the full intake process from initial referral through enrollment
• Assess participant eligibility, service needs, and program fit in collaboration with internal teams
• Coordinate intake meetings with participants, families/guardians, and referral sources
• Complete and maintain all required intake documentation and records
• Track and monitor referral pipelines, intake timelines, and service start dates across programs
• Coordinate development and implementation of Client-Specific Training (CST) with program teams
• Ensure all intake timelines are met in accordance with agency standards, funding requirements, and regulatory expectations
• Ensure timely follow-up and resolution of referrals and inquiries to prevent delays in service access

2. Community Resource Navigation & Access to Services

· Provide initial guidance and navigation to individuals and families regarding available services, funding sources, and community resources

· Assist individuals and families with understanding and accessing Medicaid Waiver services and other applicable programs

· Facilitate connections to public benefits, community resources, and external service providers as appropriate

· Maintain awareness of available community resources and service options to support informed decision-making

· Identify service gaps and communicate trends or barriers impacting access to services across programs

3. Transition Planning & Coordination

• Lead and coordinate all participant transitions in accordance with agency policy and regulatory requirements
• Facilitate transition meetings with interdisciplinary teams (IDT), ensuring timelines and expectations are met
• Coordinate housing transitions, including tours, meet-and-greets, and compatibility assessments
• Oversee transition logistics including scheduling, documentation, staffing coordination, and communication
• Ensure completion of all required transition components (risk plans, CST, BSP training, documentation, environmental checks, etc.)
• Ensure all transition timelines and required milestones are completed within established timeframes
• Lead cross-department coordination to ensure alignment, readiness, and continuity of care throughout the transition process

4. Communication & Relationship Management

• Maintain consistent and timely communication with participants, families/guardians, referral sources, and internal teams throughout the intake, enrollment, and transition process
• Maintain a working knowledge of all agency programs, services, and processes to confidently respond to questions, provide guidance, and ensure individuals and stakeholders are connected to the appropriate resources or personnel
• Build and sustain relationships with referral sources and community partners to expand access to services, housing options, and community-based resources that support quality service delivery
• Represent the organization in the community to support referral development and service awareness
• Participate in community meetings, events, or outreach opportunities as needed to maintain relationships and visibility

5. Process Oversight, Data Tracking & Continuous Improvement

• Monitor intake and transition workflows to ensure efficiency, compliance, and consistency
• Maintain accurate intake, referral, and transition data, and report on trends to support operational oversight and decision-making
• Identify process gaps and barriers impacting service access and implement improvements in collaboration with leadership
• Monitor and communicate compliance-related barriers impacting intake, enrollment, and transitions, and coordinate with appropriate departments to ensure timely resolution
• Support development and standardization of intake and transition procedures across programs
• Maintain current knowledge of Medicaid Waiver systems, agency programming, and community resources
• Participate in trainings and ongoing professional development to remain current with service delivery practices and requirements
• Stay informed of changes in community services, funding systems, and regulatory requirements
• Support continuous improvement of intake, transition, and service access processes through evaluation and collaboration with staff

6. Additional Responsibilities

• Support cross-departmental initiatives and operational projects
• Maintain flexibility to work evenings or weekends as needed based on participant transitions or operational needs
• Perform other duties as assigned

Qualifications & Experience:

· High school diploma or GED required

· Post-secondary education (certificate, associate’s degree, or higher) in Human Services or a related field preferred

· Minimum of 2 years of experience supporting individuals with intellectual and/or developmental disabilities (ID/DD), and experience in case management, intake, or service coordination required

· Valid driver’s license with an acceptable driving record required

· Must have reliable transportation to travel between locations as needed

· Experience working with Medicaid Waiver programs (CIH/FSW) preferred

· Experience coordinating transitions, housing placements, or interdisciplinary team (IDT) processes preferred

· Strong knowledge of ID/DD services, service coordination, and person-centered practices

· Understanding of Medicaid Waiver systems and community-based resources

· Excellent organizational and time management skills with the ability to manage multiple priorities

· Strong communication and interpersonal skills across diverse stakeholders

· Ability to work independently while maintaining collaboration across teams

· Proficiency in Microsoft Office (Word, Excel, Outlook) and data tracking systems

· Ability to respond effectively in high-pressure or crisis situations

Work Environment/Conditions: The Access and Transitions Coordinator primarily works in a professional office environment with frequent interaction and coordination across multiple settings, including participant homes, program sites, and community locations. This role requires regular communication with participants, families/guardians, internal staff, and external partners. The position requires the ability to manage multiple priorities, adapt to changing needs, and respond to time-sensitive situations. Occasional travel between locations is required. Flexibility in scheduling is necessary, including the ability to work evenings or weekends based on participant transitions and operational needs.

Physical Requirement: The physical demands of this position are generally light to moderate and primarily associated with office-based and community-based work. Responsibilities may include standing, walking, bending, and moving between locations for extended periods of time. The role may occasionally require lifting, carrying, or moving items such as participant belongings, supplies, or materials, typically up to 25–30 pounds. The position requires the ability to safely navigate a variety of environments, including participant homes and community settings, and to participate in transition-related activities. The ability to respond to emergency situations, including following safety procedures and coordinating appropriate support, is required. This position does not serve as a primary direct care role but may provide limited support during transitions as needed.

Schedule & Benefits:

• Flexible and traditional work schedules available for full or part-time positions.
• Opportunity to work three days a week with full-time benefits if available for one day on the weekend.
• Excellent benefits package for full-time (30 hours) employees, including:
  
  • Medical Insurance (Employee, Child, or Family)
  • Dental and Vision Insurance
  • Company-paid Life Insurance and Long-Term Disability
  • Voluntary Life Insurance
  • Employee Assistance Program (EAP)
  • Retirement Plan
  • Vacation, Sick and Personal Time
  • Employee Referral Bonus
  • Holiday Pay
  • Flexible Scheduling
  • Paid Training and Continued Education Opportunities
  • Advancement Opportunities
  • Tuition Assistance

EEO/ADA Compliant

To learn more about Easterseals ARC of Northeast Indiana and to apply online, visit our website at

Join us in making a meaningful impact! Apply today.

Equal Opportunity Employer


This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.