Remote Care Transitions Navigator

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

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