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Clinical - Transition Specialist - J01072

Mindlance

Remote-OH, OH(remote)

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JOB DETAILS
SKILLS
Activities of Daily Living (ADLs), Business Growth, Communication Skills, Diversity, Documentation, Health Plan, Healthcare, Healthcare Providers, Leadership, Long-Term Care, Medical Record System, Medical Records, Metrics, Needs Assessment, Nursing, Organizational Skills, Performance Metrics, Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Project/Program Coordination, Social Work, Standard Operating Procedures (SOP), Team Player, Time Management, Training Program, Training Program Development, Training/Teaching, Trend Analysis, Writing Skills
LOCATION
Remote-OH, OH
POSTED
25 days ago
Job Profile Summary
Position Purpose:
Provides support with identifying, overseeing, and managing the coordination of transition of members in the community. Works with leadership to ensure the timely and safe transition of members in the community from various levels of health care services including coordinating care plans with community care coordinators, educating transition enrollees about services, requirements, limitations, and/or exclusions of services as a result of the transition. May perform and/or assist with member assessment/screenings; may develop and/or assist with developing member transition plan or service plan/care plan.

Education/Experience:
Requires a Bachelor's degree and 2 4 years of related experience.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.


License/Certification:
For Health Net of California LVN/LPN State Licensure required required

Responsibilities
Supports care coordination team, providers, and/or other health care team members to develop an effective transition plan for members in the community and/or into adulthood and adult services/providers, as appropriate

Assists with the transition 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

Acts as an available resource for members and their families and/or caregivers to educate on services, requirements, limitations, and/or exclusions of services as a result of transition planning

May track and maintains transition metrics including new member assessments, volume of members transitioning into or out of care to identify trends and process improvements, and ensures all transition of care information is appropriately documented

Supports with efforts to draft education materials and resources for members on requirements, limitations, or exclusions of services for transition of care

Assists with developing education and training programs for care coordination staff and providers to improve transition services for members

May evaluate the needs of the member, the resources available, and recommends and facilitates the plan for the best outcome

May coordinate as appropriate between the member and/or family/caregivers and the care provider team to ensure members are being effectively treated

Interacts with healthcare providers as appropriate to facilitate member care coordination needs
Performs other duties as assigned

Complies with all policies and standards

EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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Story Behind the Need
  • What is the purpose of this team?
  • What is driving this need? (ex. Backfill for FTE or CW, new project, business growth)
  • Describe the surrounding team (team culture, work environment, etc.) & key projects.
  • Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?
  • This position will be assisting members in northeast ohio with SSDI applications, which requires in person connections with members in SNFs to gather information via interviewing, obtaining signatures, and also trips to the local SSA office to drop off applications and paperwork.
  • This is a new position for growth to expand cost savings throughout the state, as NEO is our largest membership population.
  • The team is diverse, respectful, supportive, and very connected although this position is highly autonomous. This role will be responsible for launching the expansion of SOAR across the state as these results will determine the future direction of expansion for this work.
  • No additional hiring needs at this time, please see above as growth depends on the success of this assignment.
Typical Day in the Role
  • Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
  • What are performance expectations/metrics?
  • What makes this role unique?
  • review SNF census, navigate internal systems, gather medical records according to detailed SOP for SOAR SSA, meet with member, interview member and family members to gather pertinent information, communicate with members with language and speech difficulties, navigate SNF environment and social workers for assistance, understand SSA nuances, submit required paperwork and follow up timely according to feedback. Organized, detailed, tasks oriented.

Click link - SOAR Training Criteria
Candidate Requirements
Education/Certification Required: Bachelor's degree OR equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Preferred:
Licensure Required: Preferred: SOAR certification
Years of experience required: 2 4 years of related experience. Social work, nursing, skilled long term care facility, experience with documentation, member facing experience with written and verbal communication skills.
ideally, some experience with SOAR applications but not required.

Disqualifiers: inability to get SOAR certified, the department will provide the soar training and cert if necessary. Short term positions on resume (please state if contract and if completed), Looking for someone that is serious/committed about moving forward with Centene.

Additional qualities to look for: SOAR Training Criteria
  • Top 3 must-have hard skills stack-ranked by importance
 1 ADL (activities of daily living); EHR clinical knowledge to read and interpret charts
2 Writing reports; completing documentation in detail , independent work and troubleshooting skills
3 Communicating with diverse populations include speech and language difficulties
Candidate Review & Selection
  • Shortlisting process
  • Candidate review & selection
  • Interview information
  • Onboard process and expectations
 Projected Manager Candidate Review Date: 1-2 days post shortlisting

Type of Interviews:
 Teams CAMERA ON
Required Testing or Assessment (by Vendor):
Next Steps
  • Do you have any upcoming PTO?
 Yes
  • Colleagues to cc/delegate
 Ronata Robinson, Director for visibility for all going forward.

About the Company

M

Mindlance