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Job description
Join VitalCaring – Where Your Passion Changes Lives!
Who We Are
Founded in 2021, VitalCaring has grown into a leading provider of home health and hospice services, with over 100 locations across the country. We are committed to fostering a culture of support, growth, and excellence for our team that is the backbone of how we ensure we deliver exceptional patient care.
What Sets Us Apart?
Meaningful work. A flexible schedule. Benefits that recognize your commitment.
This is a 16-hour-per-week weekend position designed for compassionate professionals who want to make a meaningful difference in the lives of patients and their families while maintaining balance in their own lives.
We value the time, heart, and dedication you bring to home health & hospice care—and we want our benefits to reflect that.
6 paid PTO days per year to rest, recharge, and care for yourself
Company-designated holidays are truly yours — no PTO is required to take these days off
401(k) eligibility , subject to applicable plan terms and eligibility requirements
Because caring for others starts with making sure you have the support and time you need, too.
Care Transition Navigator (CTN) – Home Health - Weekend Sat/Sun
Field-Based | Hospital-Focused | Patient Transition & Care Coordination
Role Overview
The Care Transition Navigator plays a critical role in ensuring safe, seamless transitions from the hospital to home health care. This position works directly within assigned hospital systems, partnering with case managers, physicians, patients, and families to coordinate care, reduce readmissions, and improve patient outcomes.
This is a high-impact, relationship-driven role that blends clinical insight, care coordination, and referral management to support both patient success and agency growth.
Key Responsibilities
Serve as the primary liaison between hospital teams, patients, and VitalCaring clinicians to ensure seamless transitions from hospital to home
Conduct bedside assessments to identify clinical needs, risk factors, and barriers to successful discharge
Partner with case managers and physicians to develop and execute safe, patient-centered transition plans
Drive timely admissions by coordinating referrals and ensuring smooth handoffs into home health services
Build strong, trusted relationships with hospital partners through consistent communication and follow-through
Complete post-discharge follow-up within 48 hours and ensure timely primary care coordination
Collaborate with internal teams and support initiatives focused on improving outcomes and reducing readmissions
Required Qualifications
Active RN, LVN/LPN, or PT license in the state of employment (or compact eligibility, if applicable)
Minimum of two (2) years of clinical experience; home health or post-acute experience preferred
Experience in healthcare coordination, case management, clinical care, or hospital-based roles
Strong understanding of patient care transitions, discharge planning, or post-acute services
Demonstrated ability to build relationships with healthcare providers and interdisciplinary teams
Excellent communication skills with the ability to engage patients, families, and clinicians effectively
High level of organization with the ability to manage multiple patients and priorities simultaneously
Proficiency with EMR systems and basic computer applications
Valid driver’s license and reliable transportation
Preferred Qualifications
Experience in home health, hospice, or post-acute care
Background working within hospital systems (case management, discharge planning, or bedside coordination)
Knowledge of CMS guidelines and readmission reduction strategies
Familiarity with Homecare Homebase (HCHB) or similar EMR systems
Work Environment & Expectations
Field-based role with regular presence in assigned hospitals and healthcare facilities
High-touch, patient-facing position requiring strong interpersonal and clinical communication skills
Fast-paced environment requiring adaptability, critical thinking, and proactive follow-through
Performance expectations tied to both patient outcomes and successful care transitions/admissions
Requires strong time management to balance hospital coordination, patient interaction, and documentation
All employment decisions are made without regard to race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other protected characteristic. Candidates are evaluated based on job-related qualifications, skills, and business needs.
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Worksite address
san antonio, TX, 78205, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.