Care Transitions Navigator

Cross Creek Hospital Together with Ascension Seton; Austin (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

Cross Creek Hospital Together with Ascension Seton is seeking an Outpatient Navigator to guide patients transitioning from inpatient behavioral health care into PHP/IOP or community services. You will coordinate referrals, educate families, and support discharge planning to improve continuity of care.

You will work with multiple hospital departments to confirm suitability, secure authorizations, and monitor patient engagement, aiming to reduce readmissions and strengthen care transitions within

Qualifications

• High school diploma or equivalent required.
• Bachelor’s degree in a social services-related field strongly preferred.
• Minimum of 2 years in behavioral healthcare setting (e.g., acute psychiatric hospital).

Responsibilities

• Own the full step down process—from patient identification to program admission.
• Meet every eligible inpatient and review open direct admission inquiries to facilitate referrals to outpatient.
• Educate patients and families on the value of continued care post-discharge and highlights of the hospital’s program (specialized tracks, support to address barriers to access such as transportation).
• Maintain multiple in-person check-ins during patient’s inpatient stay, including 1:1 discussions, facilitation of inpatient transitions/discharge groups, and participation in treatment team.
• Support patients with outpatient orientation/program introduction, including completion of required admissions documentation and consent forms, and introductions to PHP/IOP leaders and therapists.
• Partner with other hospital departments to facilitate step-downs, including clinical services to confirm clinical appropriateness for outpatient and include outpatient in treatment plans.
• Business office for benefits verification and copay clarifications.
• Utilization Review/Management to secure necessary authorizations and ongoing UM support as needed.
• Business development and marketing for support to convey outpatient value proposition and key messages for patient engagement.
• Outpatient Services to ensure capacity, program compatibility, and mutual awareness of discharge dates.
• Participate in daily flash meetings to review emerging step down candidates and report on PHP/IOP attendance.

Skills

Patient Engagement

Referral Coordination

Discharge Planning

Education & Support

Interdepartmental Collaboration

Education

High school diploma or equivalent

Bachelor’s degree in social services-related field preferred

Minimum 2 years in behavioral healthcare

Job description

Cross Creek Hospital Together with Ascension Seton is seeking an Outpatient Navigator to guide patients transitioning from inpatient behavioral health care into PHP/IOP or community services. You will coordinate referrals, educate families, and support discharge planning to improve continuity of care.

You will work with multiple hospital departments to confirm suitability, secure authorizations, and monitor patient engagement, aiming to reduce readmissions and strengthen care transitions within