Transitional Care Coordinator

Job overview

The Transitional Care Coordinator role is onsite in Cleveland, OH, with daytime hours approximately 8:00 a.m.–5:00 p.m. Compensation is $18.00–$19.00 per hour. Ennoble Care provides mobile primary care, palliative care, and hospice services, and this role supports continuity of care for residents in partnered facilities. The coordinator monitors residents, supports transitions after hospital discharge, and connects facility staff, families, providers, and the Housecalls division. The role helps keep care plans current, escalate changes in condition, and reduce avoidable emergency visits and readmissions.

What you'll do

• Coordinate care for patients in skilled nursing and rehabilitation facilities using the EMR
• facilitate transitional care management after hospital discharge
• expedite first provider visits
• monitor patients and communicate changes in condition
• support interventions and escalation as clinically indicated
• collaborate with providers and facility staff on care plans
• collect vital signs and conduct patient check-ins
• serve as liaison among providers, facility staff, residents, families, and Housecalls
• document interactions and reconcile charts
• support onboarding and training of new coordinators.

What we're looking for

Skills & competencies

transitional care coordinator

cleveland oh

ennoble care

certified medical assistant

care coordination

skilled nursing

rehabilitation facilities

patient monitoring

emr documentation

8:00 a.m.–5:00 p.m.

$18–$19 per hour

weekends preferred

no on-call

Work arrangement

• Weekend coverage required

Benefits & perks

• Quarterly performance bonus opportunities
• mileage reimbursement eligibility
• medical, dental, vision, and supplemental benefits
• paid time off
• paid holidays
• paid sick time
• 401(k) with up to 3% company match
• referral program
• pay-on-demand.

Why this role

Onsite facility-based role with flexible days of the week and weekends preferred; no evenings, overnight shifts, or on-call requirements.

About the employer

Ennoble Care is hiring for this role. Industry: Home Health Care Services. Sector: 62.