Transition Specialist in San Antonio, Texas at University Health System- San Antonio

POSITION SUMMARY/RESPONSIBIILITIES

The Transition Specialist-RN ensures STAR Kids Members receive early and comprehensive transition planning to help prepare them for service and benefit changes that will occur following their 21st birthday. Provides ongoing transition planning services to STAR Kids Members (starting on the Member’s 15th birthday) utilizing a team approach through the named Service Coordinator (if applicable) and with the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. The Transition Specialist considers individual dynamics, needs and preferences while providing education and health-related information on considerations and resources for Member transition out of STAR Kids. Complies with University Health’s and CFHP’s policies, procedures and protocols for establishing and maintaining good working relationships with co-workers, Health System employees, patients and guests.

EDUCATION/EXPERIENCE

Must be a licensed Social Worker. Bachelor’s degree is required and Master’s degree is preferred. All candidates must possess at least five (5) recent years of clinical experience, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of ICD10, CPT4 coding, InterQual/M&R criteria, Texas Department of Insurance HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Texas STAR+PLUS system preferred.

LICENSURE

Current state licensure from the Texas State Board of Social Work Examiners is re-quired. A healthcare related certification (such as Certified Case Manager (CCM), Certi-fied Professional in Healthcare Quality (CPHQ), Certified Pediatric Nurse (CPN), etc.) is required.