The Transition Specialist is responsible for supporting the coordination and management of member transitions across various levels of healthcare services within the community. This role works closely with care coordination teams, providers, and leadership to ensure safe, timely, and effective transitions for members, including those entering new services or transitioning into adulthood and adult care systems.

The Transition Specialist plays a key role in educating members and their families on available services, requirements, and limitations, while assisting in the development and execution of transition and care plans that promote positive health outcomes.


Key Responsibilities: 

• Support care coordination teams, providers, and healthcare stakeholders in developing and executing effective transition plans for members.
• Assist with coordinating transitions of care for members based on enrollment, service changes, or movement between care settings.
• Collaborate with care management teams to identify new members requiring transition services and ensure timely engagement.
• Ensure continuity of care by honoring existing authorizations and addressing any issues in collaboration with providers and internal teams.
• Serve as a resource for members, families, and caregivers by providing education on services, eligibility, limitations, and transition-related requirements.
• Assist with member assessments, screenings, and the development of individualized transition or service plans, as appropriate.
• Coordinate communication between members, caregivers, and healthcare providers to support effective care delivery.
• Track and maintain transition-related metrics, including assessments, transition volumes, and outcomes to identify trends and support process improvements.
• Ensure accurate and timely documentation of all transition activities and care coordination efforts.
• Support the development of educational materials and resources for members related to transition of care.
• Assist in creating and delivering training and education for care coordination staff and providers to enhance transition processes.
• Evaluate member needs and available resources to recommend and facilitate appropriate care plans.
• Interact with healthcare providers to support and facilitate member care coordination needs.
• Perform additional duties as assigned and maintain compliance with all organizational policies and standards.

Required Qualifications:

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in a healthcare-related field preferred
• Experience in healthcare, care coordination, case management, or a related field
• Strong organizational, communication, and interpersonal skills
• Ability to manage multiple priorities and work collaboratively in a team environment

Preferred Qualifications: 

• Experience in managed care, Medicaid, or community-based healthcare settings
• Familiarity with care coordination processes, transition of care, or member services
• Experience working with diverse populations, including members transitioning to adult services

About the Company: 

RepuCare is a certified woman-owned business with over 30years of experience delivering high-quality healthcare and professional staffing solutions. We are committed to operational excellence and improving outcomes through compassionate, compliant, and client-focused services.

We are currently seeking a Community Outreach Relations Specialist based in Indiana to support our client's operations.