Care Transition Specialist II

PriMed Management Consulting Services, Inc.; Swanston (CA); On-site; USD 41,000 - 47,000; Full time

Job summary

Hill Physicians Medical Group is seeking a CTC with strong administrative support to streamline pre and post-acute care, acting as a liaison among hospital clinicians, vendors, nursing facilities, and care management staff. The role emphasizes authorization processing, discharge planning, and patient outreach.

This position requires 3-5 years in managed care, excellent communication, and the ability to travel within the Bay Area and Sac-San Joaquin regions as needed, supporting timely care

Qualifications

• 3-5 years of related managed care experience required.
• Ability to coordinate effectively with a variety of customers including members, providers, hospital and office staff, health plans, internal departments, community resources, and peers.
• Excellent organizational and communication skills and ability to meet timeframes.

Responsibilities

• Inpatient: completes intake, verifies eligibility, builds referrals, and routes authorization to clinical queues within TAT requirements.
• Welcomes Home: uploads discharge summaries and coordinates post-discharge outreach and appointments within 7 days.
• Case Management: creates episodes, performs outreach, and coordinates with health plan staff or social workers as needed.
• Performs other duties as assigned. Travels to hospitals in Sacramento, San Joaquin or the Bay Area up to 100% of the time.

Skills

Medical terminology

Coordination

Time management

Communication

Education

High school diploma or GED

Tools

Microsoft Word

Microsoft Excel

EHR systems

Job description

Hill Physicians Medical Group is seeking a CTC with strong administrative support to streamline pre and post-acute care, acting as a liaison among hospital clinicians, vendors, nursing facilities, and care management staff. The role emphasizes authorization processing, discharge planning, and patient outreach.

This position requires 3-5 years in managed care, excellent communication, and the ability to travel within the Bay Area and Sac-San Joaquin regions as needed, supporting timely care