Transition Coach

Company: Springwell
Location: Waltham
Posted on: February 14, 2026

Job Description:

Job Description Job Description Join Springwell in a new and exciting partnership that supports older adults returning to the community after a hospitalization! The compensation for this role is $28.21/hr for a 37.5 hour work-week. POSITION DESCRIPTION: The Transition Coach provides support to a group of patients who have recently discharged home from the emergency room with the goal of reducing readmissions and increasing self-management skills in the community during the first 30 days of discharge. In addition to conducting home visits, the Transition Coach will provide follow up calls to each patient to offer additional support services as needed, connect the patient to community resources, and review recommendations from the in-person visit. The Transition Coach will be an integral part of an interdisciplinary team and will ensure effective communication across the team to support a smooth discharge home. QUALIFICATIONS: Bachelor’s Degree preferred, experience may be substituted. Candidates must have excellent verbal and written communication skills, and be able to independently organize work and meet deadlines. Candidates must be able to work with an interdisciplinary team across multiple agencies to effectively prioritize and address referrals and Candidates must have the ability to complete thorough assessments and identify appropriate home and community-based services and resources to meet needs. Experience with discharge planning, case management, care coordination, and/or providing referrals and resources, preferred. A reliable car, current driver’s license and safe driving record is required. GENEROUS BENEFITS: 3 weeks of vacation in first year Birthday off 13 paid holidays 3 paid personal days 15 paid sick days per year (You can accumulate up to 450hrs/12weeks) Health & dental insurance with employer contribution Life and long-term disability insurance at no cost to employee Flexible Spending Plan Employee Assistance Plan 401K Retirement Savings Plan w/ employer contribution Mileage reimbursement Flexible Work Options available after 6 months for most positions; alternate start time between 8:00 and 9:30 a.m., 4-day work week, 4.5-day work week, telecommuting work option, remote work option Employee referral bonuses Free parking Commitment to promoting from within ABOUT US: For more than 40 years, Springwell has worked to help ensure that seniors and individuals with disabilities have the village they need and the support that is necessary for them to live at home with dignity and independence. We are committed to our employees. We are focused on creating a supportive, open environment that values the people who make a difference – each and every member of our staff. We are fiercely committed to creating equal opportunities for all regardless of race, color, sex, gender identity, sexual orientation, gender expression, national origin, age, language, and physical or mental disabilities. We believe in and are looking for new staff who embrace: Accountability: At every level of the organization we are accountable: to the people we serve, to our funders, to our employees, to community professionals who rely on our support. Continuous Quality Improvement: We honor the fact that each of us is human, and we embrace a desire to examine the value and quality of our work and ask how we can provide a higher quality of service. Transparency: While we don't claim to be 100% transparent (there are certain things, like salaries and performance evaluations that are private) we continuously strive to be as open as possible. Powered by JazzHR 4ZRDg0GDHE

Keywords: Springwell, Woonsocket , Transition Coach, Social Services , Waltham, Rhode Island