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Transitional Care Coordinator Jobs (NOW HIRING)

Transitions Care Coordinator NHC HomeCare is looking for a Transitions Care Coordinator to join our team serving our Middle Tennessee area - Metro Nashville Market. The Transitions Care Coordinator ...

... coordination and support. The Transitional Care Professional plays a vital role in enhancing the ... patient experience and reducing hospital readmissions Transitional Care Professional perform visits ...

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How much do transitional care coordinator jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for transitional care coordinator in the United States is $24.35, according to ZipRecruiter salary data. Most workers in this role earn between $18.27 and $27.40 per hour, depending on experience, location, and employer.

What is a transitional care coordinator?

Transitional Care Coordinators are healthcare professionals who help patients move smoothly from one care setting to another, such as from a hospital to their home or a rehabilitation facility. They assess patients' needs, coordinate care plans, and ensure that all necessary services, medications, and follow-up appointments are arranged. Their goal is to reduce hospital readmissions, improve patient outcomes, and provide continuity of care during transitions. They often work closely with doctors, nurses, social workers, and family members to support patients throughout the process.

What skills and qualifications are needed to be a transitional care coordinator?

To thrive as a Transitional Care Coordinator, you need a background in nursing, social work, or case management, often supported by a relevant degree and clinical or care coordination experience. Familiarity with electronic health records (EHRs), patient tracking systems, and care transition protocols is typically required. Strong communication, problem-solving, and organizational skills help build rapport with patients and collaborate with healthcare teams. These competencies ensure smooth care transitions, reduce readmissions, and improve patient outcomes.

What challenges do transitional care coordinators face when helping patients move between care settings?

Transitional Care Coordinators often encounter challenges such as coordinating communication among multiple healthcare providers, managing complex medication regimens, and addressing gaps in patient education about their care plans. Ensuring that patients and their families understand discharge instructions and follow-up appointments can be particularly demanding. Additionally, Coordinators must navigate varying levels of patient engagement, socioeconomic barriers, and limited community resources, all while striving to reduce readmissions and improve overall patient outcomes.

What is the difference between Transitional Care Coordinator vs Case Manager?

AspectTransitional Care CoordinatorCase Manager
Required credentialsRN, LPN, or relevant healthcare certificationRN, social worker, or healthcare-related certification
Work environmentHospitals, clinics, post-acute care settingsHospitals, insurance companies, community agencies
Employer and industry usageHealthcare providers focusing on patient transitionsHealthcare organizations managing patient care plans
Common search intentPatient discharge, care coordinationCare planning, resource management

While both roles involve coordinating patient care, a Transitional Care Coordinator primarily focuses on ensuring smooth transitions from hospital to home or other settings, often requiring healthcare certifications. A Case Manager has a broader scope, managing overall patient care plans across various settings, often with social work or nursing credentials. Understanding these differences helps in choosing the right career path or job search focus.

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Infographic showing various Transitional Care Coordinator job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $50,639 per year, or $24.3 per hour.

RN Transitional Care Coordinator-Ahuja

University Hospitals

Beachwood, OH • On-site

Per diem

Posted 13 days ago


University Hospitals rating

7.3

Company rating: 7.3 out of 10

Based on 626 frontline employees who took The Breakroom Quiz

301st of 898 rated healthcare providers


Job description

The PRN Transitional Care Coordinator position is located at UH Ahuja Medical Center and the hours are typically 7am-3:30pm.
A Brief Overview
Ensures appropriate next site of care for patient using evidence-based decision support tools. The Transitional Care Coordinator (TCC) collaborates with all members of a patient's care team, including the family and support systems, to enhance the patient experience and ready the patient for the next site of care. The TCC develops and modifies a patient's post-acute care plan, identifies any barriers for follow-up care, brings in specialty in-hospital consultations as needed (nutrition, social work, therapy, etc.), and helps facilitate the provider hand-off to the next level of care.
What You Will Do
  • Completes assessment including patient's previous level of functioning, connection to hospital and community based resources, existing supports, SDOH. Documents comprehensive plan and facilitates necessary referrals as needed. 30%
  • Communicates and collaborates with the larger team with a multidisciplinary approach. 10%
  • Provides updates to medical team and nursing of patients plan of care and plan for the stay, discharge or movement to alternative site including but not limited to home care, SNF, IRF, Hospital at Home, or other alternative facility. (20%).
  • Develops, documents and implements a discharge plan consistent with individual patient needs and with patient and family goals. Develops plans with attention to individual patient and family goals. Discusses estimated length of stay, treatment plan and discharge plan with attending physician and/or medical team. 30%
  • Assist with recruitment, and orientation/mentoring/education of new staff.
  • Focus on readmission assessments and intercept programs/alternative services for patients not requiring an admit status (inpatient and obs).
  • Connecting patients to care (PCI, ACO, Managed Care teams).

Additional Responsibilities
  • Performs other duties as assigned.
  • Complies with all policies and standards.
  • For specific duties and responsibilities, refer to documentation provided by the department during orientation.
  • Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Qualifications:
Education
  • Graduate of an accredited school of nursing (Required) and
  • Bachelor's Degree (Preferred)

Work Experience
  • 1+ years clinical nursing experience (acute care), (Required) and
  • Experience and knowledge of utilization management, case management, post-acute transitions, and home health (Preferred)

Knowledge, Skills, & Abilities
  • Sound clinical knowledge base (Required proficiency)
  • Knowledge of Medicare, Medicaid and commercial payer regulations (Required proficiency)
  • Computer competency (Required proficiency)
  • Multi-tasks and prioritizes work (Required proficiency)
  • Works autonomously (Required proficiency)
  • Communicates effectively with persons of various backgrounds (oral and written) (Required proficiency)
  • Maintain clinical competency regarding health care delivery/regulatory requirements. (Required proficiency)
  • Teaching skills (Required proficiency)
  • Maintains a calm, professional demeanor when dealing with internal and external contacts (Required proficiency)

Licenses and Certifications
  • Registered Nurse (RN), Ohio and/or Multi State Compact License (Required Upon Hire)
  • CM certification (Preferred)

Physical Demands
  • Standing Frequently
  • Walking Frequently
  • Sitting Rarely
  • Lifting Frequently up to 50 lbs
  • Carrying Frequently up to 50 lbs
  • Pushing Frequently up to 50 lbs
  • Pulling Frequently up to 50 lbs
  • Climbing Occasionally up to 50 lbs
  • Balancing Occasionally
  • Stooping Frequently
  • Kneeling Frequently
  • Crouching Frequently
  • Crawling Occasionally
  • Reaching Frequently
  • Handling Frequently
  • Grasping Frequently
  • Feeling Constantly
  • Talking Constantly
  • Hearing Constantly
  • Repetitive Motions Constantly
  • Eye/Hand/Foot Coordination Constantly

Travel Requirements
  • 10%

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About University Hospitals

Sourced by ZipRecruiter

For more than 155 years, University Hospitals has been on a mission to heal, teach and discover. As a renowned academic medical center and community hospital network, we’ve expanded across Northeast Ohio to deliver what matters most to our patients: personalized, compassionate care; medical discovery and breakthroughs; and high-quality, affordable care close to home.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Cleveland, OH, US

Year founded

1866