Job Details

Empath Home Health is currently seeking a Transitional Care Coordinator for the Naples Team.

The Transitional Care Coordinator

• Demonstrates professional conduct and ethics according to organization policy and procedure.
• Is responsible for implementing specific patient care planning activities, such as collecting patient clinical and demographic data, planning of home health care with the attending physician and arranging for support services.
• Works cooperatively as a member of a team.
• Responds to requests for care from referring sources within the community in a timely manner.
• Obtains information to help verify insurance coverage and inform patients/physicians.
• Identifies primary and/or secondary payer of services.
• Participate in establishing the treatment plan through direct communications with the patient’s physician by obtaining specific orders of care.
• Explain the function of the health team members who will implement the plan of treatment to the patient.
• Coordinate the start of care activity with the Clinical Manager/Scheduler.
• Function as a resource for interpreting Medicare home health guidelines.
• Communicate pertinent information and instructions for specific physician orders to the health team members.
• Provide information to physicians and the community on the benefits and alternatives home health services can provide.
• Participate in and attend appropriate staff and committee meetings as directed by Empath leadership.
• Document patient care coordinating activities according to department procedures.
• Makes appropriate referrals for patients who are not accepted for care.
• Enhance personal and professional growth through attendance at workshops, conferences, and individual research and reading and/or participate in professional organizations.
• Adhere to all department policies, procedures, and standards of patient care and department guidelines.
• Perform other job duties and responsibilities as assigned by the Administration including participating in performance improvement, i.e., performance improvement groups.

Qualifications and Requirements:

• Registered, licensed and certified by the State of Florida to practice as a RN, LPN, PT, PTA, OT or RT preferred.
• Minimum of two (2) years of home care experience, preferably one year experience in writing referrals and coordination of services from hospital or skilled nursing facility to home.
• Demonstrates knowledge of community resources and the medical community.
• Clinical knowledge and evaluation skills with experience in reviewing patient charts.
• Understanding of the home health care delivery system and patient eligibility.
• Competent computer skills.
• Excellent organizational, problem-solving and decision-making skills.
• Knowledge and experience in state and federal laws and regulations applicable to home health care.

Empath Health values diversity as it strengthens our community and care. We embrace the diversity of cultures, thoughts, beliefs and traditions of our employees, volunteers and people we are honored to serve across our network. Our diverse staff reflects our community and each day, we work to be respectful, sensitive and competent with each other and those in our care. In every journey, we are dedicated to achieving comfort, dignity and exceptional care. Those of all backgrounds are welcome and encouraged to apply with us or seek our care and services.

Our commitment to patient, client, staff and volunteer safety is a cornerstone of a High Reliability Organization with a focus on zero harm. Participation in the seasonal influenza is a condition of employment and a requirement for all Empath Health employees.

Providing compassionate, full life care is an honor we take seriously at Empath Health. Join our team and make a positive impact in the community!