Transition Coordinator I-DSS (Hybird, North Carolina Based)

The Transition Coordinator I- DSS role will provide an episodic support role to the member’s multidisciplinary care team (MCT) when member physical and/or behavioral needs are identified.  These consultants offer on-demand recommendations and complete administrative assessments and provide education to achieve the best health outcomes for the member. This role will be supervised by a licensed clinician.

This is a full-time remote opportunity. There is no expectation of being in the office routinely, however, the selected candidate must be available to travel in the community as needed.  The selected candidate must reside in North Carolina

Responsbilities & Duties

Conduct Assessments and Planning

• Assist the Care Manager with members transitioning to the community from institutional care settings to community-based care 
• Utilize person centered planning, motivational interviewing and assessments to review information and develop rapport with the members supported
• Obtain necessary releases of information that will improve care management activities on behalf of the member 
• Provide education and supports to members and legal guardians regarding their rights and responsibilities, available service options, providers availability, and payer requirements that may impact service connection and maintenance 
• Actively collaborate with members supported and members of the planning team to ensure development of a plan that accurately reflects the individual’s needs and desired life goals 
• Ensure that assessments and plans are updated, as needed, whenever the members’ life circumstances change 
• Complete Administrative assessments/ plans of care for the needs identified in the assessments and complete the interventions identified as needed

Conduct Monitoring/Coordination

• Review assessments, crisis plans and care plans to ensure physical health needs and ensure there is a response to treatment plan for members 
• Escalate high risk/high visibility and/or complex barriers/needs members who may have SDOH/Behavioral/Physical needs to the Care Manager for additional supports
• Promote customer satisfaction through ongoing communication and timely follow-up on any concerns/issues  
• Coordinate and facilitate case staffing with DSS and other stakeholders to plan for and communicate care needs as needed. 
• Participate in Child/Adult Team meeting in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate
• Verify that initial service linkage is completed through monitoring of activities in JIVA

Documentation/ Administrative Duties

• Ensures all documentation (e.g. goals, plans, progress notes, etc.) meet state, organization, and Medicaid requirements
• Monitor documentation to ensure that issue/errors are resolved 
• Follow administrative procedures and effectively manage caseload
• Provide support to team members in meeting the needs of the DSS population
• Participate in Division/Unit Meetings and individual supervision
• Provide feedback to team and supervisor about member experiences, gaps, and strengths in services to meet the needs of the DSS  population

Minimum Requirements

Education & Experience

Bachelor’s degree in a human services field or licensure as a RN plus two (2) years of relevant experience working directly with individuals with SED or SMI; 

or

Master’s degree in a human services field or licensure as a RN plus one (1) year of relevant experience working directly with individuals with SED or SMI. 

Knowledge, Skills, & Abilities

• Knowledge of resources and systems in the community that can assist with eliminating SDOH barriers to treatment and whole person living
• High level of diplomacy and discretion 
• Problem solving, negotiation, arbitration and conflict resolution skills 
• Skilled at shifting between macro and micro level planning
•  Detail oriented
• Ablility to organize multiple tasks and priorities, and to effectively manage projects from start to finish
• Quickly adapts to mandated changes and priorities within the department  
• Ability to change the focus of his/her activities to meet changing priorities  
• Proficiency in Microsoft Office products (such as Word, Excel, Outlook, PowerPoint, etc.) 

Salary Range

$25.00 to $32.50/Hourly

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.   

 An excellent fringe benefit package accompanies the salary, which includes: 

• Medical, Dental, Vision, Life, Long and Short Term Disability
• Generous retirement savings plan
• Flexible work schedules including hybrid/remote options
• Paid time off including vacation, sick leave, holiday, management leave
• Dress flexibility