Transition Planner

Amae Health; Los Angeles (CA); On-site; USD 70,000 - 115,000; Full time

Job summary

Amae Health seeks a dedicated Transition Planner - Social Worker to facilitate patient transitions from inpatient care to ongoing support. You will collaborate with a multidisciplinary team to ensure continuity of care and advocate for patients' needs in the Los Angeles area. This role offers a unique opportunity to contribute to transforming the lives of individuals living with severe mental illness through compassionate support and integrated care.

Benefits

Comprehensive medical, dental & vision plans

401(k)

Paid Time Off

Parental Leave - 12 weeks

Employee Assistance Program

Short & long-term disability

FSA & HSA savings programs

Pre-tax commuter assistance program

11 company holidays

Qualifications

• 1+ years of patient-facing experience as a social worker, discharge planner, or transition planner.
• Active California license preferred (LCSW, LMFT, LPC).
• Knowledge of mental health and social service systems in Los Angeles.

Responsibilities

• Represent Amae Health in ER and inpatient settings to coordinate patient transitions.
• Support thorough patient screenings in hospitals or communities.
• Function as a patient advocate to facilitate access to necessary services.

Skills

Communication

Patient Advocacy

Organizational Skills

Adaptability

Education

Bachelor’s or Master’s degree in Social Work

Job description

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Transforming the lives of those affected by severe mental illness

At Amae Health, we are dedicated to helping the 15.4 million Americans living with severe mental illness (SMI) lead stable, meaningful lives, while ending the cycle of repeat hospitalizations. In partnership with some of the nation’s top academic medical centers we’ve pioneered an innovative outpatient care model that combines compassionate, in-person psychiatric care with comprehensive wraparound support. Our integrated care teams — including psychiatrists, therapists, primary care physicians, health coaches, and peer support specialists — work together to treat the whole person via a unique model, addressing physical, mental, and social needs in unison. By caring for every aspect of our patients’ well-being, we help them not just survive, but truly thrive.

Amae Health is a Series A venture-backed Public Benefit Corporation dedicated to becoming the nation's center of excellence for individuals living with severe mental illness (SMI). Backed by top-tier venture capital firms and strategic healthcare investors, we collaborate with prestigious health systems including NewYork-Presbyterian, Stanford Healthcare, and Cedars-Sinai, underscoring our commitment to fundamentally transforming mental health care delivery at scale.

The Team

At Amae we are a collective of healthcare operators on a mission to create a radically different patient-first behavioral health care model that truly transforms patient’s lives by integrating care delivery, patient experience, cutting edge technology and research. Join a team of operators, builders and technologists from One Medical, Forward Health, Stanford, UCLA, Hinge Health, Palantir, The Four Seasons, and Brightline as we redefine care for the most vulnerable populations - across the nation, at scale.

The Opportunity

We are growing our presence in the Los Angeles! As we build out our multidisciplinary team, we are hiring a Transition Planner - Social Worker to support our patients in their transition from inpatient care to care at Amae. Reporting to the Chief Strategy Officer with a dotted line to the Clinic Director, you will work across inpatient and emergency units at collaborating acute care facilities to support patient’s transition plans, bridging the gap in patient’s care journeys and meeting patients where they are at to connect them with the care they need.

What You Will Work On

• Represent Amae Health in the ER and inpatient hospital setting with our academic medical center partners to coordinate patient transitions to Amae, ensuring continuity of care as patients begin their care journey with Amae Health
• Support the Amae patient journey through conducting thorough patient screenings either in the hospital or in the community
• Function as a patient advocate, supporting access to necessary health and social services
• Collaborate with a multidisciplinary team and establish and maintain trust and rapport with patients, families and teammates
  
  

About You

A true patient advocate, you excel in using your knowledge of Los Angeles Area's health systems and services to connect patients to the most appropriate resources in order to support their care journeys. Strong communication skills and an inherent ability to build trust are your hallmarks, and you are passionate about initiating, establishing and maintaining relationships with patients and families that are founded on trust and rapport. You are adaptable, flexible and organized, people centered, and excited about the opportunity to be part of a team that is changing how SMI care is delivered in our community.

What You’ll Have

• A Bachelor’s or Master’s degree in Social Work (BSW or MSW) is required. An active, unrestricted California license is preferred—such as a Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), or Licensed Professional Counselor (LPC).
• 1+ years of patient facing experience as a social worker, discharge planner or transition planner in a hospital setting
• Knowledge of and familiarity with the mental health and social service systems in the Los Angeles Area and an understanding of patient rights and a holistic perspective of “health”
• Demonstrated skill and adaptability in working with people from diverse backgrounds in a variety of settings
• Comfort working one-on-one or in group settings, with experience facilitating workshops, events or activities
• Excellent communication skills and a strong desire to collaborate with others in a team based environment and community settings
• Organized with strong attention to detail and the ability to navigate and learn new technologies and platforms, familiarity with EHR systems and Google Suite desired
  
  

What We Provide

Amae Health is proud to offer a comprehensive benefits package to take care of you now and in the future, focusing on your personal, financial and professional wellness.

• Health Insurance: Comprehensive medical, dental & vision plans
• Employee Assistance Program
• 401(k)
• FSA & HSA savings programs
• Short & long-term disability
• Pre-tax commuter assistance program
• Paid Time Off
• Parental Leave - 12 weeks for birth and non birth parent
• 11 company holidays
  
  

Amae Health is committed to fair and equitable compensation practices.

Base salary range for this role is $70,000 to $115,000 per year based on a full-time schedule. Actual compensation packages are based on several factors that are unique to each candidate. These factors include, but are not limited to, job related knowledge and skill set, depth of experience, certifications, degrees, licensures, and specific work location.

More About Amae

'Amae', pronounced ‘Ah-mai’, is a Japanese concept meaning the need to be in good favor with, and the ability to depend on, the people around oneself. It reflects our core belief that a strong support system is essential to build people up, strengthen their will to carry on and even to thrive in life. This mentality applies across our whole company – from the patients we serve to the team we’re building.

We’re a Public Benefit Corporation (PBC) that provides outpatient psychiatric and primary care health services through value-based care arrangements. Our model’s success is predicated upon achieving outcomes for our patients, not on the volume of services provided.

Amae Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Mental Health Care

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