What are the responsibilities and job description for the Home Health Care Transition Coordinator position at FC Compassus LLC?
Company :
Ascension at Home Together with Compassus
Position Summary
The Home Health Care Transition Coordinator is responsible for modeling the Compassus values of Compassion, Integrity, Excellence, Teamwork, and Innovation and for promoting the Compassus philosophy, using the 6 Pillars of Success as the foundation. S / he is responsible for upholding the Code of Ethical Conduct and for promoting positive working relationships within the company, among all departments, and all external stakeholders. The Home Health Care Transition Coordinator serves as a trusted resource for the physician and hospital case managers and communicates with referral sources. S / he conducts skilled conversations with physicians, patients, families, and healthcare providers. S / he maintains an understanding of hospital and post-acute healthcare systems. The Home Health Care Transition Coordinator navigates getting patients into the right care at the right time.
Position Specific Responsibilities
- Meets regularly with physicians in the hospital to discuss specific patients : gives guidance and provides an understanding of post-acute service support; ensures continuity of care as a priority.
- Acts as hospital case managers (rounding or interactions in step with the hospital) : high-risk patient reviews.
- Supports transition to home health, home infusion, and hospice services by conducting in-person bedside transitions; where services are offered.
- Educates on hospice, home infusion, and home health benefits to patient families and referral sources.
- Develops genuine collegial relationships with other Ascension professionals and identifies times to meet regularly with clinicians to problem solve and review cases.
- Understands how to interact with difficult patients / families.
- Identifies steps to having a successful family meeting.
- Develops communication skills to support patients / families with difficult discussions or differing points of view.
- Maintains a current list of admission coordinators for each healthcare service line.
- Aligns recommendations between patient / family and Primary care team :
Identifies patient preferences / needs.
Understands how to identify patient / family-specific treatment goals.
Education and / or Experience
Certifications, Licenses, and Registrations
Physical Demands and Work Environment : The demands of this role necessitate a team member to effectively perform essential functions. Adaptations can be made to accommodate team members with disabilities. Regular standing, walking, and manual dexterity are fundamental, along with the ability to lift and move objects up to 50 pounds. Visual acuity requirements include close and distance vision, color and peripheral vision, depth perception, and the ability to adjust focus. In a healthcare setting, exposure to bodily fluids, infectious diseases, and conditions typical to the field is expected. Routine use of standard medical equipment and tools associated with clinical care is essential. This description provides a general overview and may vary by role and department, capturing the nuanced demands and conditions inherent to clinical positions in our organization.
At Compassus, including all Compassus affiliates, diversity, equity, and inclusion are fundamental to our Pillars of Success. We are committed to creating a fair work environment where our team members feel welcomed, highly valued, and respected. As an equal opportunity employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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