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Ambulatory Transition Care Coach - Care Center
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Full-time
- The Ambulatory Transitional Care Coach is responsible for providing outreach and care coordination to patients recently discharged from an inpatient or observation hospital setting.
- Documents all necessary components of the transitional care management visit.
- Responsible for initiating the medication reconciliation by tasking and notifying the appropriate care teams of patient discharge.
- Communicates with case management to provide care coordination to ensure the plan of care facilitates the efficient use of health care resources.
- Acts as a liaison between referral sources, facilities, and external entities to prevent and/or resolve continuum of care issues.
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