Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Quick apply
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Quick apply
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Quick apply
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Quick apply
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Quick apply
Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge ...
Assists the department manager with administrative duties to include scheduling, performance ... Consistent with duties for Transitional Care RN's: designs, implements, and fosters care transition ...
New
Assists the department manager with administrative duties to include scheduling, performance ... Consistent with duties for Transitional Care RN's: designs, implements, and fosters care transition ...
New
Annapolis, MD · On-site
$41.91 - $62.86/hr
Assists the department manager with administrative duties to include scheduling, performance ... Consistent with duties for Transitional Care RN's: designs, implements, and fosters care transition ...
New
Annapolis, MD · On-site
$41.91 - $62.86/hr
Assists the department manager with administrative duties to include scheduling, performance ... Consistent with duties for Transitional Care RN's: designs, implements, and fosters care transition ...
New
Linthicum, MD · On-site
$422K/yr
This unique role supports patients transitioning from acute inpatient hospitalization to home through a virtual care model focused on early intervention, symptom management, education, care ...
Linthicum, MD · On-site
$422K/yr
This unique role supports patients transitioning from acute inpatient hospitalization to home through a virtual care model focused on early intervention, symptom management, education, care ...
This unique role supports patients transitioning from acute inpatient hospitalization to home through a virtual care model focused on early intervention, symptom management, education, care ...
This unique role supports patients transitioning from acute inpatient hospitalization to home through a virtual care model focused on early intervention, symptom management, education, care ...
$19.50 - $26.50/hr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
$19.50 - $26.50/hr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
Washington, DC · On-site
$74K - $134K/yr
Is recognized as a professional role model and Case Management Care Co-ordination readmission ... Ensures patients' referral process and transition into specialty services are timely and efficient ...
Washington, DC · On-site
$74K - $134K/yr
Is recognized as a professional role model and Case Management Care Co-ordination readmission ... Ensures patients' referral process and transition into specialty services are timely and efficient ...
Largo, MD · On-site
$237K/yr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
Largo, MD · On-site
$237K/yr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
Linthicum Heights, MD · On-site
$19.25 - $26/hr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
Linthicum Heights, MD · On-site
$19.25 - $26/hr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
La Plata, MD · On-site
$237K/yr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
La Plata, MD · On-site
$237K/yr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
$19.25 - $26/hr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
$19.25 - $26/hr
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
Job Requirements The Case Management Coordinator is responsible for outreaching heart failure ... Transitional Care Support Conduct post-discharge and post-acute Transition of Care (TOC) calls.
Fairfax, VA · On-site
$18.25 - $23.25/hr
Inova Transitional Care in Fairfax is looking for a dedicated Medical Assistant 2 to join the team ... Reports patient safety issues to the physician and practice manager in a timely manner. Provides ...
Fairfax, VA · On-site
$18.25 - $23.25/hr
Inova Transitional Care in Fairfax is looking for a dedicated Medical Assistant 2 to join the team ... Reports patient safety issues to the physician and practice manager in a timely manner. Provides ...
Washington, DC · On-site
$74K - $134K/yr
General Summary of Position The Transitional Care Coordinator coordinates patient care and ... Is recognized as a professional role model and Case Management Care Co-ordination readmission ...
Washington, DC · On-site
$74K - $134K/yr
General Summary of Position The Transitional Care Coordinator coordinates patient care and ... Is recognized as a professional role model and Case Management Care Co-ordination readmission ...
Hanover, MD · On-site
$31.25 - $36.06/hr
Support post-discharge follow-up and Transitional Care Management (TCM) workflows for patients recently discharged from hospital or emergency department settings, including timely outreach within 7, ...
Hanover, MD · On-site
$31.25 - $36.06/hr
Support post-discharge follow-up and Transitional Care Management (TCM) workflows for patients recently discharged from hospital or emergency department settings, including timely outreach within 7, ...
$31.25 - $36.06/hr
Support post-discharge follow-up and Transitional Care Management (TCM) workflows for patients recently discharged from hospital or emergency department settings, including timely outreach within 7, ...
Quick apply
$31.25 - $36.06/hr
Support post-discharge follow-up and Transitional Care Management (TCM) workflows for patients recently discharged from hospital or emergency department settings, including timely outreach within 7, ...
General Summary of Position The Transitional Care Coordinator coordinates patient care and ... Is recognized as a professional role model and Case Management Care Co-ordination readmission ...
General Summary of Position The Transitional Care Coordinator coordinates patient care and ... Is recognized as a professional role model and Case Management Care Co-ordination readmission ...
$35.7K - $42K
19% of jobs
$44.7K is the 25th percentile. Wages below this are outliers.
$42K - $48.3K
14% of jobs
The median wage is $52.9K / yr.
$48.3K - $54.7K
23% of jobs
$54.7K - $61K
13% of jobs
$66.8K is the 75th percentile. Wages above this are outliers.
$61K - $67.3K
6% of jobs
$67.3K - $73.7K
6% of jobs
$73.7K - $80K
9% of jobs
$80K - $86.3K
5% of jobs
$86.3K - $92.7K
3% of jobs
$92.7K - $99K
1% of jobs
$99K - $105.3K
0% of jobs
$35.7K
$59.9K
$105.3K
A Transitional Care Management professional is responsible for coordinating and overseeing a patient's care as they move between different healthcare settings, such as from hospital to home. Daily duties often include assessing patient needs, developing individualized care plans, facilitating communication between healthcare providers and family members, and ensuring all necessary follow-up appointments and medications are in place. They also work to identify and address potential barriers to recovery, such as social or environmental factors, to prevent hospital readmissions. The role involves close collaboration with physicians, nurses, social workers, and community resources to provide comprehensive support throughout the transition process.
A Transitional Care Management (TCM) job involves coordinating care for patients as they transition from a hospital or skilled nursing facility back to their home or community setting. TCM professionals, such as nurses or care coordinators, ensure that patients receive follow-up care, medication management, and necessary support to prevent complications or hospital readmission. They communicate with healthcare providers, educate patients on their conditions, and address any barriers to recovery. The goal of TCM is to improve patient outcomes and enhance the continuity of care during this critical period.
To thrive in Transitional Care Management, you need clinical expertise in patient care coordination, discharge planning, and chronic disease management, usually supported by a healthcare degree such as nursing, social work, or a related field. Familiarity with electronic health records (EHRs), care planning software, and current transitional care guidelines is highly valued, along with certifications like CCM (Certified Case Manager) or TCM (Transitional Care Management) when available. Outstanding organization, problem-solving, and interpersonal communication are essential soft skills for building relationships with patients, families, and multidisciplinary teams. These abilities are crucial for ensuring seamless transitions, reducing readmissions, and improving patient health outcomes during vulnerable periods of care transfer.

Full-time
Re-posted yesterday
4.2
Based on 6 frontline employees who took The Breakroom Quiz
About Us
Ennoble Care is a mobile primary care, palliative care, and hospice service provider with patients in New York, New Jersey, Maryland, DC, Virginia, Oklahoma, Kansas, Pennsylvania, Texas, Florida, and Georgia. Ennoble Care's clinicians go to the home of the patient, providing continuum of care for those with chronic conditions and limited mobility. Ennoble Care offers a variety of programs including, remote patient monitoring, behavioral health management, and chronic care management, to ensure that our patients receive the highest quality of care by a team they know and trust. We seek individuals who are driven to make a difference and embody our motto, "To Care is an Honor." Join Ennoble Care today!
Ennoble Care is seeking a full-time Certified Medical Assistant to serve as a Transitional Care Coordinator within one or more of our partnered long-term care facilities in Prince George's County, Maryland. The right person for this role is reliable, self-motivated, vigilant, and compassionate. This is an integral, on-site role as part of our clinical care team, working closely alongside our providers in a family-practice-style model built around continuity, relationship-building, and patient-centered support.
You'll get to know the residents (and their families) over time, monitor for changes in condition, and play a meaningful, hands-on role in helping people stay healthy, avoid unnecessary hospitalizations, and remain in their home -- where many of them want to be.
We're proud of the culture we've built at Ennoble Care -- one that is positive, respectful, and rooted in genuine teamwork. People here are valued, supported in doing work that matters, and encouraged to maintain a healthy work-life balance. We invest in our team's growth through internal advancement opportunities based on performance, organizational needs, and role availability, because we believe that when our team thrives, so do our patients.
ABOUT THE ROLE
At Ennoble Care, our mission is simple: To care is an honor. For our patients, that means we come to you, we care for you, and we're here for you -- and that belief is at the heart of everything we do. As a CMA Transitional Care Coordinator, you'll bring that mission to life -- working on-site within one or more of our partnered skilled nursing and rehabilitation facilities in Prince George's County, Maryland. Your focus will be transitional care management, attentive patient monitoring, and day-to-day collaboration with our clinical team and facility staff -- serving as a reliable communication bridge among residents, families, facility staff, and our Housecalls division -- keeping everyone informed and care on track.
REQUIRED QUALIFICATIONS
Please note, travel between facilities may be required
KEY RESPONSIBILITIES
Care Coordination & Transitional Care Management
On-Site Clinical Support
Communication & Collaboration
Documentation & EMR Management
Team Support & Leadership
COMPENSATION & BENEFITS
Please answer all application questions thoroughly.
Thank you for your interest in joining the Ennoble Care team!❤️
#brown
Full-time employees qualify for the following benefits:
All employees qualify for these benefits:
Candidates must disclose any current or future need for employment-based immigration sponsorship (including, but not limited to, OPT, STEM OPT, or visa sponsorship) before an offer of employment is extended.
Ennoble Care is an Equal Opportunity Employer, committed to hiring the best team possible, and does not discriminate against protected characteristics including but not limited to - race, age, sexual orientation, gender identity and expression, national origin, religion, disability, and veteran status.
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Health care and social assistance
201 - 500 Employees
Hackensack, NJ, US