Care Coordination Specialist

About the role

The Care Coordination Specialist will function as a key member of an interdisciplinary, value-based care delivery model, collaborating with patients, nursing, physicians, advanced practitioners, caregivers, and community partners to optimize clinical, quality, and financial outcomes.

Responsibilities

• Provide comprehensive care coordination and interdisciplinary discharge planning processes for patients ensuring appropriate utilization of post-acute resources, reduce avoidable readmissions, and support accurate risk stratification.
• Integrate clinical, social, and economic determinants of health into individualized care planning, ensuring alignment with patient acuity, developmental stage, and payer requirements.
• Proactively identify and address barriers impacting transitions of care, including social determinants of health (SDOH), to enhance patient outcomes and support appropriate risk adjustment and reimbursement optimization.
• Perform transition of care management, including timely coordination of services, facilitation of medically necessary referrals, initiating post-acute authorizations if applicable, assisting with transportation needs, and effective linkage to community-based resources to ensure continuum of care.
• Apply strong organizational and operational management skills to coordinate multiple high-impact workflows, supporting compliance with regulatory requirements, efficient length of stay management, and improved performance in value-based reimbursement models.

Position Details

Location: Winter Haven Hospital - Winter Haven, FL
Status: Part time, 16 hours per week
Schedule: Saturday & Sunday 8:30 AM - 5:00 PM
Weekend Requirement: Every
On Call: No

Education And/or Licensure

• Bachelor's degree in social work, psychology, or healthcare related field OR
• HS Graduate or Equivalent GED and LPN License.

Experience

• Medical Social Work or LPN experience preferred

Benefits

• Health, Dental, Vision
• Paid time off
• Tuition reimbursement
• 401k match and additional yearly contribution
• Yearly performance appraisals and team award bonus
• Community discounts and more