Post Care Transitions Specialist (North Central)

Trillium Health Resources; Hart's Location (NH); Remote; USD 56,000 - 70,000; Full time

Benefits offered by this job

Health insurance with no employee-prem

401k with employer match

PSLF qualifying employer

Quarterly remote work stipend

PTO and holidays

Job summary

Trillium Health Resources is seeking a Post Care Transitions Specialist to coordinate treatment planning, assessment, monitoring, education, and linkage for individuals in the Transitions to Community Living Initiative (TCLI). This role focuses on complex physical, behavioral health, and social determinant needs, with discharge planning across adult care settings.

You will work with clinicians and peer support to ensure timely transitions, complete assessments, and thorough documentation in

Qualifications

• Must meet QP status: Fully licensed by the NC governing board regulating Human Services professions; OR Fully licensed RN licensed in NC with 4 years MH/DD/SA experience.
• License and/or certification may be accepted as noted.
• Must reside within Trillium’s North Central Region (Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, Wilson) and be able to travel within catchment.
• Must be legally authorized to work in the United States without sponsorship now or in the future.

Responsibilities

• Collaborate with licensed Clinicians, RNs, and Peer Support Specialists to ensure discharge/transition planning and post-transition monitoring.
• Provide care coordination/management to TCL individuals with behavioral and physical health needs.
• Assess needs of members in supportive housing to determine additional support for independent living.
• Complete assessments as needed.
• Document planning and coordination efforts accurately in multiple software platforms and State databases.

Skills

Driver's license

Education

Licensed by NC governing board

RN license in NC

Master’s degree in human services

Bachelor’s degree in human services

Job description

Pay Plan Title: Post Care Transitions Specialist

Working Title: Post Care Transitions Specialist

FLSA Status: Exempt

Posting Salary Range: $56,270 - $69,898

Office Location: Remote within Trillium’s North Central Region (See requirements section for included counties)

Posting Details

Make an Impact

Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.

Why Work for Us ?

• A collaborative, mission-driven work environment
• Competitive benefits and work-from-home options for most positions
• Opportunities for professional growth in a diverse inclusive culture

Every day, our work changes lives – from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.

What We’re Looking For

Trillium Health Resources has a career opening for a Post Care Transitions Specialist to join our team! The Post Care Transitions Specialist is responsible for providing care coordination (treatment planning, assessment, monitoring, educating, and referral/linking) to individuals identified in the Transitions to Community Living Initiative Special Needs Populations (TCLI) by targeting those with chronic, unresolved, or complex physical, behavioral health, and social determinant needs. The Post Care Transitions Specialist will provide care planning as well as discharge and transition planning from Adult Care Homes, inpatient units, and detention centers with foundations in national evidence based and informed standards providing whole person care.

On a Typical Day, You Might

• Work collaboratively with licensed Clinicians, Registered Nurses, and Peer Support Specialists to ensure successful discharge/transition planning/post transition monitoring.
• Provide care coordination/care management to assigned TCL individuals who may have identified needs with behavioral health, physical health, co-occurring, co-morbid, or multi-morbid conditions.
• Assess members’ needs who have transitioned into supportive housing to determine if additional support and services are needed for continued independent living.
• Complete assessments as needed.
• Ensure timely and accurate documentation of all planning and coordination efforts in multiple software platforms and State database systems.

Employee Benefits

• Typical working hours: 8:30 am – 5:00 pm, flexible work schedules with some roles with management approval.
• Work-from-home options available for most positions
• Health Insurance with no premium for employee coverage
• Flexible Spending Accounts
• 24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year
• NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook
• 401k with 5% employer match and immediate vesting
• Public Service Loan Forgiveness (PSLF) qualifying employer
• Quarterly stipend for remote work supplies

Required

Qualifications

• Must meet QP status:
• Fully licensed by the NC governing board regulating Human Services professions; OR
• Fully licensed RN who is licensed to practice in the state of NC by the NC Board of Nursing who also has four (4) years of full-time experience with the MH/DD/SA population served. OR
• A graduate of a college or university with a Master’s degree in a human service field and has one year of full-time, pre or post-graduate degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has one year of full-time, pre or postgraduate degree accumulated supervised experience in alcoholism and drug abuse counseling; OR
• A graduate of a college or university with a bachelor's degree in a human service field and has two years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has two years of full-time, pre or post bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling; OR
• A graduate of a college or university with a bachelor's degree in a field other than human services and has four years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has four years of full-time, pre or post-bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling.
• License and/or certification may be accepted as noted.
• Must have a valid driver’s license.
• Must reside within Trillium’s North Central Region, which includes the following counties: Beaufort, Dare, Edgecombe, Greene, Hyde, Nash, Pamlico, Pitt, Tyrrell, Washington, and Wilson.
• Must be able to travel within catchment as required.
• Must be legally authorized to work in the United States without requiring sponsorship for employment now or in the future (ex: OPT F-1, J-1).

Preferred

• Experience and knowledge of peer support and experience working with individuals who are certified peer support specialists.
• Bachelor's in human services field with 3+ years’ experience with the MHSU population.

Deadline for Application

Thursday November 12, 2026, at 11:59PM

Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.