MANAGER OF TRANSITIONAL CARE - STROGER

Job Summary

The Manager of Transitional Care serves as a key member of the clinical services team, working in collaboration with inpatient care coordination and integrating transition of care services across all health plans and uninsured patient populations. Using evidenced based practices, is responsible for developing programs, goals, and processes to support members experiencing transitions levels of care, care providers/settings or program eligibility.

Typical Duties

• Develops program description work plans and annual program goals for transitions of care, for approval by leadership and oversight committees.
• Analyzes data and conducts monthly/quarterly/annual evaluation of work plan to identify program successes as well as barriers/impediments to achieving performance benchmarks.
• Recognizes trends, identifies opportunities, and assess financial impact to design and lead improvement initiatives.
• Utilizes data and experiences of members, providers, and partners to make recommendations to leadership regarding network providers.
• Develops relationships with transition stakeholders, e.g., large volume hospitals, CCH staff, ACHN leadership, and community organizations.
• Prepares reports for various audiences, makes, and implements recommendations for improvement.
• Develops, organizes, and manages workflows, processes, and job aids to support the provision of transition related activities and assesses ability to promote desired outcomes as well as comply with regulatory requirements and vendor agreements.
• Researches, develops, and implements TOC interventions that will increase use of health care, improve health, and promote cost-effectiveness of health care utilization.
• Collaborates and coordinates people and systems to leverage health plan care coordination and CCH resources.
• Fosters strong relationships with diverse stakeholders from all community sectors.
• Engages and works collaboratively with contracted/delegated care management entities and medical management staff, vendors, behavioral and physical health providers, and social services to assure integration of direct health care services.
• Provides oversight of vendors, including facilitation of vendor meetings, monitoring of key performance indicators, and collateral outcomes.
• Provides and facilitates training for partners.
• Supports regulatory compliance and effective participation in broader care delivery systems and mandates.
• Participates in the development of information technology systems for optimal information sharing across entities and care settings.
• Facilitates and promotes timely problem identification, analysis, and resolution.

Minimum Qualifications

• Bachelor's degree from an accredited college or university is required (Must provide official transcript at the time of interview)
• Licensed as a Registered Nurse, Licensed Clinical Social Worker (LCSW), or Licensed Clinical Professional Counselor (LCPC) in the State of Illinois, or have the ability to obtain Illinois license prior to starting employment, is required
• Two (2) years of work experience in a health care setting, such as home care, physician's office/ambulatory care, acute care, is required
• Two (2) years of supervisory or management work experience is required
• One (1) year of care coordination work experience is required
• One (1) year of work experience pertaining to transition related activities is required

Preferred Qualifications

• One (1) year working on transition related activities within a community-based, hospital-based, or health plan setting is preferred
• One (1) year of experience working with Medicaid and/or Medicare population is preferred