Care Transition Navigator

Responsibilities

• Serve as the primary liaison between hospital teams, patients, and VitalCaring clinicians
• Conduct bedside assessments to identify clinical needs and discharge barriers
• Partner with case managers and physicians to execute patient-centered transition plans
• Drive timely admissions by coordinating referrals and ensuring smooth handoffs
• Build strong, trusted relationships with hospital partners
• Complete post-discharge follow-up within 48 hours
• Collaborate with internal teams to improve outcomes and reduce readmissions

Requirements

• Active RN, LVN/LPN, or PT license in the state of employment
• Minimum of two years of clinical experience
• Experience in healthcare coordination, case management, or hospital-based roles
• Strong understanding of patient care transitions and discharge planning
• Proficiency with EMR systems and basic computer applications
• Valid driver’s license and reliable transportation

Preferred Qualifications

• Experience in home health, hospice, or post-acute care
• Background working within hospital systems
• Knowledge of CMS guidelines and readmission reduction strategies
• Familiarity with Homecare Homebase (HCHB)

Benefits

• Medical, Dental, and Vision coverage
• Pharmacy benefits and virtual care support
• 401(k) with company match
• Generous paid time off
• Tuition and continuing education reimbursement
• Pet insurance and identity theft protection

About the Company

Founded in 2021, VitalCaring is a leading provider of home health and hospice services with over 100 locations across the country.