RN Transition Specialist — Hybrid Care Coordination Leader

Centene Corporation; New Hampshire; Hybrid; USD 42,000 - 76,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase

Tuition reimbursement

Paid time off

Flexible work arrangements

Job summary

Centene Corporation in New Hampshire is seeking a Transition of Care Specialist to oversee coordination of member transitions across healthcare services. The role involves collaborating with care teams, educating enrollees about services, and ensuring timely, safe transitions.

Responsibilities include coordinating with providers, reviewing authorizations, developing education materials for members and staff, and maintaining thorough transition documentation.

Qualifications

• Bachelor's degree and 4-6 years related experience.
• RN is highly preferred in New Hampshire Health Families.

Responsibilities

• Works with care coordination team, providers, and other health care team members to develop an effective transition plan for members in the community.
• Assists with the transition of care for members in the community based on enrollment or transition of care for services identified.
• Works with care coordination and care management team to identify new member enrollees requiring transition services.
• Ensures existing authorizations are honored during the transition process and works with care management team and providers to address any issues.
• Educates members and families about services, requirements, limitations, and exclusions as a result of transition planning.
• Reviews transition metrics and ensures transition information is documented.
• Partners with leadership to identify process improvements for transition of care.
• Assists with developing education materials and training programs for staff and providers.
• Evaluates member needs and coordinates plan for best outcomes.
• Coordinates between members/families and care provider teams to ensure effective treatment.

Skills

Transition of care

Care coordination

Member education

Communication with providers

Education

Bachelor's degree

Job description

Centene Corporation in New Hampshire is seeking a Transition of Care Specialist to oversee coordination of member transitions across healthcare services. The role involves collaborating with care teams, educating enrollees about services, and ensuring timely, safe transitions.

Responsibilities include coordinating with providers, reviewing authorizations, developing education materials for members and staff, and maintaining thorough transition documentation.