Manager, Care Transition Office

NTUC HEALTH CO-OPERATIVE LTD; Singapore; On-site; SGD 120,000 - 180,000; Full time

Job summary

NTUC HEALTH CO-OPERATIVE LTD seeks a Manager for the Care Transition Office to drive centralized assessment coordination and ensure seamless integration of NTUC Health’s services within the ICCP framework.

The role will lead the InterRAI CU assessment process, optimize handoffs across Senior Care Centres, Home Care and Community Services, and advance a unified single care plan for clients.

Qualifications

• Minimum 5 years of clinical, social work, or care assessment experience in eldercare or community health settings.
• Certified InterRAI Assessor (or eligible/willing to undergo immediate certification).
• Strong process optimization and change management skills.
• Strong interpersonal and engagement skills.
• Analytical mindset with the ability to interpret assessment workload data.

Responsibilities

• Assessment Capability Scoping & Management: Establish guidelines for centralized assessment support across NTUC Health facilities; lead workload assessment (up to 4 assessors).
• Internal Care Coordination Optimization: Streamline onboarding and transfer processes and standardize handoffs.
• One Care Plan Strategy Integration: Contribute to design, pilot, and evaluation of journey-based integration models for a single client record.
• Quality & Regulatory Compliance: Ensure workflows adhere to MOH and internal governance.
• Team Supervision (Phase 2): Recruit, onboard, train and supervise junior Care Assessors.

Skills

Assessment & workload planning

Interpersonal engagement

Process optimization

Change management

Critical thinking

Education

Degree in Nursing, Social Work, Occupational Therapy, Physiotherapy, or Healthcare Management

Tools

InterRAI CU

EMR / Care management system

Job description

The Care Transition Office (CTO) ensures seniors receive continuous care as they come into and move between different NTUC Health services within Integrated Community Care Provider (ICCP) framework.

Its role includes:

• Connecting Services:Serving as the main link between hospitals, social services, and NTUC Health's and ICCP's various care options - like home care, nursing homes, and active ageing centres to make sure clients have a smooth experience.
• Improving Care Journeys: Creating clear and efficient referral processes so seniors can easily move from hospital care to community support, and within community care services as their needs evolve, without delays.
• Boosting Teamwork: Leading efforts to identify gaps in care, simplify how we work together, and make our services easier for seniors and their families to access.

Manager, Care Transition Office

plays a critical dual role: establishing NTUC Health's centralized assessment capability and driving internal care transition integration. As the lead for this function, this role will scope assessment workload demand (InterRAI CU), optimize care coordination handoffs between services, and support NTUC Health in achieving the aim of a single care plan for clients .

Key Responsibilities

• Assessment Capability Scoping & Management:Establish operational guidelines for centralized assessment support (InterRAI CU) across Senior Care Centres, Home Care, and Community Social Services; directly conduct assessments while evaluating workload volume to determine future team scaling (up to 4 assessors). Be willing and able to eventually become a master trainer for InterRAI for an envisaged train-the-trainer model.
• Internal Care Coordination Optimization: Streamline internal onboarding and transfer processes, working closely with Care Coordinators across NTUC Health to standardize handoffs and eliminate transition bottlenecks.
• "One Care Plan" Strategy Integration: Contribute towards the design, pilot, and evaluation of journey-based integration models that unify multidisciplinary care plans into a single client record.
• Quality & Regulatory Compliance: Ensure all assessment workflows adhere to AIC guidelines, MOH regulatory standards, and internal clinical/social governance frameworks.
• Team Supervision (Phase 2): Recruit, onboard, train and supervise junior Care Assessors as assessment demand expands.

You should have:

• A Degree in Nursing, Social Work, Occupational Therapy, Physiotherapy, or Healthcare Management.
• Minimum 5 years of clinical, social work, or care assessment experience in eldercare or community health settings, with demonstrated project or team leadership.
• Certified InterRAI Assessor (or eligible/willing to undergo immediate certification).
• Strong process optimization and change management skills, with experience navigating cross-division workflows.
• Strong interpersonal and engagement skills.
• Analytical mindset with the ability to interpret assessment workload data to inform manpower planning.

It would be great if you:

• Possess prior involvement in health system integration, pilot project implementations, or EMR/care management system redesigns.
• Hold advanced qualifications in Gerontology or Healthcare Operational Excellence (e.g., Lean/Six Sigma).