Transitions Coordinator – Post Acute

CareSource

. Monitor and manage member level-of-care transitions to and from long-term care, respite nursing facility services, and HCBS waiver services .

Posted 11/10/2026full-timeRemote • Ohio • United StatesMid-LevelSenior💰 $62,700 - $100,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in case management and care coordination, with a strong focus on managing member transitions and maintaining benefit eligibility. Proficient in clinical documentation, compliance standards, and interdisciplinary collaboration within healthcare settings.

Highest-signal resume keywords

Registered Nurse (RN) LicensureCase Management ExperienceKnowledge of Medicare and MedicaidClinical Documentation SkillsExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical ReviewCare Plan DevelopmentData AnalysisAssessment SkillsBenefit Management

Soft Skills

Organizational SkillsCritical ThinkingCustomer Service OrientationDecision-Making SkillsTime Management Skills

Tools & Technologies

Microsoft Office SuiteWindows-Based EnvironmentClinical Documentation SystemMobile Communication Devices

Certifications & Qualifications

Licensed Social Worker (LSW)Licensed Independent Social Worker (LISW)

Industry Keywords

Long-Term CareHome and Community-Based Services (HCBS)Interdisciplinary Care TeamQuality ImprovementFederal and State Regulations

About the role

Key responsibilities & impact

Monitor and manage member level-of-care transitions to and from long-term care, respite nursing facility services, and HCBS waiver services
Manage enrollment and disenrollment of home and community-based waiver services through clinical review and benefits management
Partner with care coordination, waiver service coordination staff, and other stakeholders as part of the interdisciplinary care team
Complete nursing-facility level-of-care reviews, respite request reviews, and waiver enrollment/disenrollment processes
Verify member eligibility, enrollment history, and demographics
Monitor and assist members in maintaining benefit eligibility during transitions
Coordinate and document clinical reviews and requested services in the clinical documentation system
Support appeals processes and gather clinical documentation
Coordinate discharge planning and safe transitions between levels of care
Review medical records, contacts, treatment plans, case notes, referrals, and assessments for compliance and accreditation
Assist with care plan development and implementation
Attend interdisciplinary team meetings, State Hearings, and Medical Advisement meetings when requested
Escalate care coordination needs and refer quality issues to Quality Improvement
Maintain knowledge of federal and state regulations, CareSource contracts, provider agreements, and Medicare/Medicaid benefits
Precept and mentor new staff
Participate in special projects or research
Maintain required reporting and assist with data analysis

Requirements

What you’ll need

Completion of an accredited Registered Nurse (RN) degree program or degree required to obtain Social Worker licensure in the State of Ohio
Current, unrestricted Registered Nurse (RN), Licensed Social Worker (LSW), or Licensed Independent Social Worker (LISW) licensure in the State of Ohio
Three (3) years of experience in case management and/or managed care
Intermediate proficiency in Microsoft Office Suite
Basic knowledge of a Windows-based environment
Ability to operate a smartphone, iPad, or other mobile communication devices
Excellent written and verbal communication skills
Ability to work with diverse populations in a non-judgmental manner
Ability to work independently and within a team
Strong organizational skills
Excellent assessment skills
Attention to detail
Knowledge of Medicare and Medicaid
Critical thinking and listening skills
Time management skills
Customer service orientation
Decision-making and problem-solving skills
Knowledge of evidence-based medical criteria and/or standards of care

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Substantial and comprehensive total rewards package
In-person meeting attendance may be required
Travel is not typically required