About Texas Children's Hospital
Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org
for career opportunities. You can also learn more about our amazing culture at infinitepassion.org
We are searching for a Transition Specialist - someone who works well in a fast-paced hospital setting. In this position, you’ll be responsible for deployment of transition awareness for Members by age 10 and development of a transition plan for Members aged 15 years and above.
Think you’ve got what it takes?
- Develops and maintains satisfactory business relationships with participating providers in adult and pediatric networks
- Collaborates with Member/LAR and service coordination team to develop, implement and monitor member transition plan
- Identifies educational needs within the provider network and initiates educational efforts as needed or upon provider request to expand capacity of adult network willing to accept transitioning Members
- Reviews and interprets all relevant information with Member/family and develops/initiates a transition plan and self-management plan with family during an in-home assessment
- Sends communication and makes first contact to Members at age 10 regarding need to apply for waivers and LTSS services as applicable
- Travels to Member homes for periodic evaluation and assessment of unmet functional needs, educational needs and goal attainment seeking Member/LAR input in transition plan
- Monitors service delivery to members including satisfaction and quality of services
- Delivers exceptional customer service to contracted providers and Members
- Ensures thorough communication and education to Members/providers an understanding of delivery system capabilities to improve access and address Member needs
- High School diploma or GED
- Three (3) years of experience in health care. This can be satisfied as experience as a parent of a child with special healthcare needs
- Community Health Worker certification is preferred
- Experience in health care, local and state programs for children with disabilities or managed care setting is preferred
- Strong Customer Service background – heavy telephonic interactions with our families and members
- Flexible and the ability to adapt to changes – pivotal in the STAR Kids program and will require changes as needed to meet State expectations
- Comfortable driving and being in families homes - Members age 20 and older or as requested require a face to face visit
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