Care Transition Coordinator

The Care Transition Coordinator (CTC) plays a pivotal role in facilitating seamless transitions for patients from healthcare facilities to home health or hospice care. This position is responsible for evaluating patient eligibility, coordinating care plans, and ensuring all services—including ancillary needs such as DME and infusion—are arranged in alignment with agency protocols and patient needs. The CTC serves as a liaison between the agency, referral sources, and healthcare providers, ensuring timely communication, documentation, and patient education. By executing strategic outreach plans and managing sales-related administrative functions, the CTC supports market growth, maintains compliance with financial stewardship, and enhances patient satisfaction through personalized, informed care transitions. Adoration Home Health and Hospice Achieve monthly personal production goals and Medicare-certified (MC) admission targets for assigned locations. Manage sales and marketing expenses to ensure financial stewardship and return on investment. Implement weekly, monthly, and quarterly strategies to increase market share within assigned facilities. Evaluate patients and physician orders for home care eligibility in accordance with Right of Choice guidelines. Conduct face-to-face patient transitions to provide agency education and identify the primary care physician responsible for the plan of care. Complete Care Transition Coordinator (CTC) encounter documentation in Home Care Home Base. Educate patients on home care or hospice orders and related services received from the referral source. Ensure all patient needs identified by the referral source are documented and addressed by the agency upon acceptance. Perform sales administration duties including BOA expense entry, adherence to BOA policies and procedures, payroll timesheet submission, participation in weekly 3LS meetings, submission of PTO requests, and attendance at required sales calls and company-provided in-services. Maintain timely communication via phone and email. Notify discharge planning of active patients transferred from home health to a facility. Coordinate resumption of care with patients prior to discharge when applicable orders are obtained. Provide follow-up feedback to the case management team on readmission status and non-admit decisions based on agency-provided information. Maintain patient confidentiality in accordance with applicable laws and agency policies. Educate medical professionals using appropriate tools and literature. Required: Minimum of one (1) year of experience in home health or hospital-based case management. Preferred: One (1) to three (3) years of experience in medical marketing or healthcare business development. Current and active licensure in the state of practice as a Registered Nurse (RN), Licensed Practical Nurse (LPN), Social Worker (SW), or Physical Therapist (PT) is required. Must possess a valid driver’s license, reliable transportation, and current auto insurance. Adoration Home Health and Hospice, an affiliate of BrightSpring Health Services, provides quality and compassionate services in the comfort of home, providing support for patients, families, and caregivers in their time of need. Adoration was formed to fill the need for a loving, community-focused, caring organization. We empower patients to live with dignity, find a sense of fulfillment, and celebrate with their families a life well-lived. For more information, please visit Follow us on Facebook and LinkedIn.