Transitional Care Specialist - Licensed Behavioral ...

Job Summary As a Transitional Care Specialist, you will be essential in ensuring smooth and effective transitions for members moving from hospital settings to their homes or other care facilities. Your primary mission is to guarantee top-quality care during this critical shift, with the goal of decreasing readmission rates and enhancing member well-being. Essential Job Duties: Provide dedicated support to members across a comprehensive 30-day transitional care program starting from hospital admission. Collaborate effectively with hospital discharge planners, healthcare providers, and support networks to facilitate safe transitions. Conduct thorough assessments to ensure members receive adequate caregiving, medical oversight, and functional support. Work alongside ancillary providers and public agencies to secure essential services and equipment for seamless transitions. Perform in-person visits during hospital stays and follow up with home visits for high-risk members post-discharge as needed. Utilize the Coleman Care Transition model to coordinate ongoing care and reassess member needs after discharge. Educate and empower members in seven key areas pertinent to their transition, including medication management and symptom recognition. Apply motivational interviewing techniques to assist members in effectively managing their health. Identify any barriers to care and provide tailored assistance to address and resolve these issues. Lead interdisciplinary care team meetings to foster and enhance collaboration among team members. Provide guidance and education to non-behavioral health care managers when necessary. Be prepared to travel locally 40-50% of the time, in accordance with state or contractual guidelines. Required Qualifications: A minimum of 2 years of healthcare experience, with at least 1 year in hospital discharge planning, care management, or behavioral health settings. Current and unrestricted licensure as a behavioral health clinician (LCSW, LPC, LMFT, etc.) in your state of practice. Valid driver's license, reliable transportation, and suitable auto insurance for travel. Experience with or knowledge of the Care Transitions Intervention model. Strong understanding of community resources and support systems available to members. Detail-oriented mindset with proactive problem-solving abilities. Ability to communicate effectively and adapt to diverse populations. Self-motivated, able to work independently, and manage multiple priorities. Exceptional verbal and written communication skills. Proficient in Microsoft Office Suite and related software applications. Preferred Qualifications: Certification in transitions of care or as a Certified Case Manager (CCM). Experience in hospital discharge planning or home health services. Molina Healthcare provides a competitive compensation package, including comprehensive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $26.41 - $59.21 / HOURLY Compensation may vary based on geographic location, work experience, education, and skills.

Created: 2026-03-04