Job Description

Job Details: Level: Entry,

Job Location: Bluestem PACE - McPherson, KS 67460,

Position Type: Full Time, Education Level: Prefer High School grad or GED,

Travel Percentage: Minimal,

Job Shift: Day,

Job Category: Admin - Clerical, Bluestem PACE is looking for a full-time Transition Specialist & Onboarding Liaison to join our team!

Join our team and enjoy outstanding benefits!

At Bluestem Communities, we value our full-time team members and offer a benefits package designed to support both your personal and professional well-being. As a full-time employee you can enjoy the following benefits:

Health and insurance

• Health, dental and vision insurance
• Flexible Spending Accounts (medical & childcare available)
• AFLAC products
• Voluntary life insurance

Financial wellness

• 401(k) plan with company match
• Gradifi student loan payment program
• Payactiv: Early access to earned wages

Company-paid benefits

• Group term life and AD&D insurance
• Short-term disability insurance
• Employee Assistance Program (EAP)

Time off and perks

• Paid Time Off (PTO) and six (6) paid holidays
• Bluestem Wellness Center membership
• Meal discounts at our dining locations

Our benefits are designed to help you thrive both personally and professionally. Explore the full range of benefits and learn more about how Bluestem Communities can be the right fit for you—visit our Careers page today!

Position Overview

The Transition Care Specialist & Onboarding Liaison serves as the central point of coordination for supporting participant transitions across care settings while onboarding new employees. This role facilitates effective communication, ensures seamless integration of new team members, and promotes continuity of care for participants by coordinating transitions between hospitals, skilled nursing facilities, home care, and the PACE center. The position works collaboratively with interdisciplinary team members, community partners, participants, caregivers, and leadership to ensure a positive onboarding experience and successful care transitions.

Essential Job Functions

Transition Care Responsibilities

• Initiate and manage Transition Work Plans for all participant transitions, including new enrollees, emergency room visits, hospitalizations, respite stays, and discharges to home.
• Audit Transition Work Plans to ensure compliance and effectiveness, providing education, guidance, and follow-up with IDT members as needed.
• Communicate with participants, caregivers, providers, and community partners to facilitate safe and timely transitions.
• Review discharge plans and ensure follow-up services are arranged.
• Monitor the EMR after transitions to identify barriers, gaps in care, or potential readmission risks.
• Ensure required documentation is completed accurately and on time.
• Educate participants and caregivers regarding care plans, follow-up appointments, medications, and available resources.
• Track transition outcomes and identify opportunities to improve participant experience and quality outcomes.
• Participate in quality improvement initiatives related to care coordination and transitions.
• Coordinating home visits for transition coordination to discharging participant home from respite.

Onboarding Liaison Responsibilities

• Serve as the primary contact for newly hired employees from offer to acceptance through completion of orientation.
• Coordinate onboarding activities, orientation schedules, and department introductions.
• Ensure completion of onboarding requirements, including training assignments, policy acknowledgments, and required documentation.
• Communicate regularly with new hires to answer questions and provide support during the onboarding process.
• Collaborate with Human Resources, department leaders, and educators to facilitate a smooth transition into assigned roles.
• Monitor onboarding progress and follow up on outstanding requirements.
• Coordinate welcome activities and promote employee engagement during orientation and onboarding.
• Track onboarding metrics and identify opportunities for process improvement.
• Assist with retention initiatives by conducting check-ins with new employees during their first 90 days.

: Qualifications and Experience:

• Must be proficient with electronic medical records and Microsoft Office applications.
• Must have thorough knowledge of medical terminology.
• Prefer a minimum of two years of experience in healthcare coordination, case management, human resources, onboarding, customer service, or LPN.
• Prefer experience in PACE, long-term care, managed care, or healthcare transitions.
• Prefer experience coordinating multiple priorities and maintaining confidentiality.
• Prefer strong interpersonal and relationship-building skills.
• Prefer excellent written and verbal communication abilities.
• Prefer the ability to manage multiple tasks and deadlines effectively.
• Prefer knowledge of healthcare systems, community resources, and care coordination principles.
• Prefer strong organizational and problem-solving skills.
• Prefer the ability to work independently and as part of an interdisciplinary team.
• Prefer demonstrated commitment to customer service and participant-centered care.

Physical Requirements

Light Work – Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently. Requires walking or standing to a significant degree; or requires sitting most of the time but entails pushing and/or pulling of arm or leg controls.