Continued Stay Coordinator

The Continued Stay Coordinator is responsible for facilitating and coordinating continued stay eligibility determinations to ensure participants remain eligible for services under applicable regulatory, contractual, and organizational requirements. This role conducts periodic functional eligibility reviews, analyzes clinical and non‑clinical information, and collaborates with interdisciplinary teams to support timely, accurate continued stay decisions. The position plays a critical role in regulatory compliance, continuity of care, and audit readiness.

Essential Functions and Responsibilities

• Facilitate Continued Stay Reviews (CSRs) by making referrals to agencies for the Level of Care (LOC).
• Serve as case manager until certification is obtained for annual continuation of PACE services.
• Facilitate continued stay reviews in accordance with federal, state, and program‑specific eligibility requirements
• Conduct periodic functional eligibility reassessments using clinical documentation, assessments, and interdisciplinary input
• Collect, review, and analyze supporting medical, functional, and psychosocial information to determine continued eligibility
• Coordinate continued stay review schedules and ensure reviews are completed within required timeframes
• Prepare and maintain comprehensive eligibility documentation, determinations, and supporting rationale in designated systems
• Collaborate with interdisciplinary team members (e.g., clinical staff, care coordinators, social services, enrollment, compliance) to support continued stay determinations
• Identify and escalate potential eligibility risks, gaps, or changes in participant status that may impact continued stay
• Communicate continued stay outcomes, requirements, and next steps to internal stakeholders and, as appropriate, participants or authorized representatives
• Ensure compliance with regulatory standards, program contracts, and organizational policies related to continued stay and eligibility
• Support audits, reviews, and appeals by providing accurate documentation and responding to eligibility inquiries
• Maintain strict confidentiality of participant information in accordance with HIPAA and organizational standards

Travel: 0% to 2%

Knowledge, Skills, and Abilities

• Knowledge of continued stay review processes and functional eligibility requirements
• Familiarity with healthcare regulatory frameworks (e.g., Medicaid, long‑term care, or PACE‑related eligibility standards)
• Strong analytical skills with the ability to interpret clinical and functional information
• High attention to detail and accuracy in documentation and determinations
• Effective written and verbal communication skills, including explaining eligibility decisions clearly
• Ability to manage multiple cases, prioritize deadlines, and work independently
• Proficiency with electronic health records, case management, or eligibility systems
• Ability to exercise sound judgment and professionalism in complex or sensitive situations

Education and Experience

Required:

• High school diploma or equivalent
• Minimum of two years of experience in eligibility determination, continued stay reviews, utilization review, case management, or related healthcare roles

Preferred:

• Associate’s or Bachelor’s degree in healthcare administration, social work, nursing, public health, or a related field
• Experience supporting continued stay, utilization management, or regulatory eligibility reviews in a healthcare setting

InnovAge is dedicated to empowering seniors to live independently, allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge, our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge, you'll work alongside talented, respectful, and passionate colleagues within a patient-centered care model.

InnovAge is committed to equal opportunity and affirmative action, and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race, color, religion, sex, sexual orientation, gender identity/expression, national origin, disability, protected veteran status, pregnancy, or any other protected status. Salaries are determined by various factors such as qualifications, experience, and location, and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance, short and long-term disability, life insurance and AD&D, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays.

Applicants are considered until the position is filled.

Compensation Disclaimer

The pay may vary depending on job related factors, such as work location, experience, knowledge, skills, education, certifications, training and internal equity.  InnovAge offers a comprehensive benefits package, which includes medical, dental, vision, 401(k) plan with company match, short and long-term disability, life insurance, supplemental life insurance, ADD, flexible spending account, paid time off and company paid holidays.

Attention Florida Applicants
This position requires a background screening through the Florida Care Provider Background Screening Clearinghouse.
For more information, please visit the Clearinghouse Education and Awareness website:  https://info.flclearinghouse.com

Agency Disclaimer

InnovAge will not accept unsolicited resumes from search firms for this employment opportunity. Regardless of past practices, all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.

Fraud Disclaimer

InnovAge is committed to maintaining a safe, transparent, and respectful hiring process for all candidates.

Please be aware that all legitimate email communication regarding InnovAge job opportunities will come exclusively from an email address ending in @innovage.com. 

At no point in our hiring process will InnovAge:

• Request payment from candidates for equipment, background checks, onboarding, training, or any other employment‑related purpose
• Ask for financial information (such as bank account details) before a formal offer and onboarding process is completed through our official systems

If you receive a message claiming to represent InnovAge that does not align with the above, it may be fraudulent. We encourage you to exercise caution and refrain from engaging or sharing personal information.

If you believe you have been contacted by someone misrepresenting InnovAge, please report the activity to HRAnswers@innovage.com or apply directly through our official career site to ensure the opportunity is legitimate.

Your trust matters to us, and we appreciate your interest in joining InnovAge.