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Care Transition Specialist (Medicare)

•Remote (PA/NJ/DE) 🔍 Philadelphia, Pennsylvania New 📁 Health & Clinical Services 📅    1 day ago Post Date 📅    261132 Requisition # Apply for Job Share this Job Sign Up for Job Alerts Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve. Summary The Care Transition Specialist is responsible for supporting members as they transition from inpatient care to home or another care setting. This role ensures continuity of care, reduces avoidable readmissions, and promotes positive health outcomes through proactive outreach, education, and coordination of services. Responsibilities Member Outreach & Engagement Contact members post-discharge to review discharge instructions, identify current needs, and escalate immediate needs to clinical team. Educate members on medication adherence, symptom monitoring, and follow-up appointments. Identify social determinants of health barriers and connect members to appropriate resources. Assists members with understanding their plan benefits and connects to member services. Care Coordination Assist with scheduling follow-up visits with network providers and specialists. Facilitate referrals to home health, durable medical equipment, and community-based services as needed. Collaborates with interdisciplinary team (nurse health coach and/or social workers) for consultation and referrals. Monitoring & Documentation Documents member outreach outcomes and barriers to care using health plan care management systems within scope of role. Document all interactions in compliance with organizational, regulatory, and NCQA standards. Monitor high-risk members and escalate concerns to clinical case managers as needed. Requirements Bachelor's degree in health sciences, psychology, social work, or related field, nursing, public Health, or related field required. Medical Assistant certificate preferred. 1-2 years of experience in relevant work experience (healthcare, member-facing role such as case management and member outreach). Experience with transition of care calls offering post discharge support and patient engagement. Knowledge of managed care principles, discharge planning, and community resources. Strong communication and interpersonal skills. Excellent written and verbal communication skills. Ability to work independently and manage multiple priorities

Fully Remote:

This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence's physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania. Inclusion and Belonging At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. About Our Company Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day. At Independence, we see each of our members as an individual, with unique needs and concerns. We're dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com . We're revolutionizing health care, and our focus is on you! Equal Employment Opportunity IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. Agency Disclaimer All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process. Current Associates Applying for a position? Click here to return to the internal career site. Current Associates My Profile Create and manage profiles for future opportunities, and review prior submissions. Go to Profile Similar Listings Executive Assistant

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