The Transition Coordinator is a member of the clinical leadership team who is responsible for planning, directing, organizing, implementing, coordinating and developing resident admission, discharge and liaison processes. Promotes quality service in accordance with Casey’s Pond, state and federal regulations.
- Treats residents and guests in a manner to ensure their complete satisfaction and strives to exceed customer expectations; incorporates principles of EDEN in all activities and interactions.
- Receives referrals for admission into the Doak Walker House and Grove and Harbor neighborhoods from local hospitals, hospice, home and other referring bodies.
- Coordinates assessments and reviews present issues, medical, social and psychological history, medications and financial information to determine if admission is appropriate to the Community.
- Conducts face-to-face assessments when possible with potential resident and families to determine appropriate admission and communicate expectations from both parties.
- Makes recommendations on appropriate neighborhood placement and presents for final approval to the Director of Nursing and/or Director of Assisted Living.
- Coordinates and schedules admissions and in-house move-ins and move-outs with all related departments for Doak Walker House and Grove and Harbor neighborhoods.
- Coordinates paperwork, records and files relating to current and prospective residents from referring agent.
- Presents and explains admission packet to residents and family members. Ensures paperwork is completed on a timely basis.
- Coordinates and leads Admission Conferences with new resident, families and Interdisciplinary Team (IDT).
- Coordinates and evaluates other care conferences, care plan updates and IDT meetings including discharge plan, rehab and transition goals.
- Leads the IDT in discharge planning from the time of admission to create a safe discharge plan for our Med A residents and to ensure the wishes of the long term care is maintained.
- Builds and maintains positive and professional relationships by working as a liaison and contact person with local hospitals, doctors offices and other health resources and partnerships within the surrounding community.
- Participates in surveys and other inspections made by authorized governmental agencies; is responsible for complying with statutory and regulatory standards.
- Serves as backup for MDS Coordinator and Social Services.
- Utilizes sound judgment and experience to solve moderately complex problems in adherence with Casey’s Pond Employee Handbook and Behavioral Code of Ethics.
- Performs other duties as assigned in line with HIPAA compliance.
Note: This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his or her supervisor.
Education and Experience
- Associate Degree, Bachelor’s Degree preferred.
- Knowledge of a variety of insurance regulations including Medicare and Medicaid regulations.
- Extensive clinical knowledge of appropriate diagnosis for Medicare A Admissions and Long Term Care.
- 1 - 3 years of experience in admissions/discharges preferably in a health care facility.
- Must possess excellent organizational and computer skills.
- Must be able to read, write and speak the English language.
- Must be familiar with electronic medical records. Matrix experience preferred.
- Registered RN preferred, but not required
- Ability to stand, walk, sit, feel, reach, bend, stoop, crouch, talk, hear, and see
- Ability to lift, carry, push, and pull up to 20 lbs.
- Excellent interpersonal and communication skills for interacting with residents, guest and fellow associates
- Possible exposure to blood-borne pathogens, various drugs, chemical, infectious, communicable diseases or biological hazards
- Subject to injury from falls, burns, odors, or cuts from equipment
- Weekend, evening or night work as needed
Uses independent judgment to make decisions based on precedents and established guidelines. Solves problems using standard procedures and precedents. Knows when to refer issues to supervisor and when to handle them personally.
Knowledge and Skills
Possesses extensive knowledge of a distinct skill or function and a thorough understanding of the organization and work environment. Has working knowledge of a functional discipline. Basic typing and computer skills are essential preferably in a Microsoft Windows environment. Must have working knowledge of facility emergency procedures including fire and disaster drills. Ability to follow facility policies. Ability to maintain resident confidentiality and adhere to HIPAA policies.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The qualifications listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.