Transition Of Care Jobs
Transition Of Care jobs are open across hospitals, health systems, managed care organizations, and home health agencies, from coordinator to manager and director levels, with common specializations in discharge planning, care coordination, and utilization management. Find a role that fits from the openings below and apply directly.
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Showing 5 of 39+ Transition Of Care jobs
JOB DESCRIPTION
This is a hybrid role. Since your team is based in Thurston/Mason County, you will also need to be located there.
Job Summary
Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure that best possible services are available to members at time of hospital discharge and focuses on goal to reduce member readmissions. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Follows member throughout a 30-day program that starts at hospital admission and continues oversight through transitions from acute setting to all other settings, including nursing facility placement/private home, with the goal of reduced readmissions.
- Ensures safe and appropriate transitions by collaborating with the hospital discharge planner, as well as collaborating with hospitalists, outpatient providers, facility staff, and family/support network.
- Ensures member transitions to setting with adequate caregiving and functional support, as well as medical and medication oversight support.
- Works with participating ancillary providers, public agencies or other service providers to make sure necessary services and equipment are in place for safe transition.
- Conducts face-to-face visits of all members while in the hospital and, home visits high-risk members post-discharge as needed.
- Coordinates care and reassesses member needs using the Coleman Care Transition model post-discharge.
- Educates and supports member focusing on seven primary areas (Transition of Care Pillars): medication management, use of personal health record, follow-up care, signs and symptoms of worsening condition, nutrition, functional needs and or home and community-based services, and advance directives.
- Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
- Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
- Facilitates interdisciplinary care team meetings (ICT) and collaboration.
- Provides consultation, recommendations and education as appropriate to non-behavioral health care managers.
- 40-50% local travel may be required (based upon state/contractual requirements).
Required Qualifications
- At least 2 years' experience in health care, with at least 1 year of experience in hospital discharge planning, care management or behavioral health setting, or equivalent combination of relevant education and experience.
- Licensed behavioral health clinician to include Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT), Doctor of Psychology (PhD or PsyD). License must be active and unrestricted in state of practice.
- Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
- Knowledge of or experience using the Care Transitions Intervention (CTI) or similar model.
- Background in discharge planning and/or home health.
- Demonstrated knowledge of community resources.
- Proactive and detail oriented.
- Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
- Ability to work independently, with minimal supervision and demonstrate self-motivation.
- Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
- Ability to develop and maintain professional relationships.
- Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
- Excellent problem-solving, and critical-thinking skills.
- Excellent verbal and written communication skills.
- Microsoft Office suite/other applicable software program(s) proficiency.
Preferred Qualifications
- Transitions of care sub-specialty certification and/or Certified Case Manager (CCM).
- Hospital discharge planning or home health experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
JOB DESCRIPTION
This is a hybrid role. Since your team is based in Thurston/Mason County, you will also need to be located there.
Job Summary
Provides support for care transition activities. Facilitates transitional care processes and coordination for member discharge from hospital admission to all other settings. Strives to ensure that best possible services are available to members at time of hospital discharge and focuses on goal to reduce member readmissions. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
- Follows member throughout a 30-day program that starts at hospital admission and continues oversight through transitions from acute setting to all other settings, including nursing facility placement/private home, with the goal of reduced readmissions.
- Ensures safe and appropriate transitions by collaborating with the hospital discharge planner, as well as collaborating with hospitalists, outpatient providers, facility staff, and family/support network.
- Ensures member transitions to setting with adequate caregiving and functional support, as well as medical and medication oversight support.
- Works with participating ancillary providers, public agencies or other service providers to make sure necessary services and equipment are in place for safe transition.
- Conducts face-to-face visits of all members while in the hospital and, home visits high-risk members post-discharge as needed.
- Coordinates care and reassesses member needs using the Coleman Care Transition model post-discharge.
- Educates and supports member focusing on seven primary areas (Transition of Care Pillars): medication management, use of personal health record, follow-up care, signs and symptoms of worsening condition, nutrition, functional needs and or home and community-based services, and advance directives.
- Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
- Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
- Facilitates interdisciplinary care team meetings (ICT) and collaboration.
- Provides consultation, recommendations and education as appropriate to non-behavioral health care managers.
- 40-50% local travel may be required (based upon state/contractual requirements).
Required Qualifications
- At least 2 years' experience in health care, with at least 1 year of experience in hospital discharge planning, care management or behavioral health setting, or equivalent combination of relevant education and experience.
- Licensed behavioral health clinician to include Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), Licensed Marriage and Family Therapist (LMFT), Doctor of Psychology (PhD or PsyD). License must be active and unrestricted in state of practice.
- Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
- Knowledge of or experience using the Care Transitions Intervention (CTI) or similar model.
- Background in discharge planning and/or home health.
- Demonstrated knowledge of community resources.
- Proactive and detail oriented.
- Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
- Ability to work independently, with minimal supervision and demonstrate self-motivation.
- Responsive in all forms of communication, and ability to remain calm in high-pressure situations.
- Ability to develop and maintain professional relationships.
- Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
- Excellent problem-solving, and critical-thinking skills.
- Excellent verbal and written communication skills.
- Microsoft Office suite/other applicable software program(s) proficiency.
Preferred Qualifications
- Transitions of care sub-specialty certification and/or Certified Case Manager (CCM).
- Hospital discharge planning or home health experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
See All 39+ Transition Of Care Jobs
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Find Transition Of Care JobsTransition Of Care Job Market
A snapshot from current openings nationwide, updated as new roles post.
Who's Hiring
- Molina Healthcare14
- CVS Health7
- Beth Israel Lahey Health2
- Hackensack Meridian Health2
- Trinity Health2
Top Industries Hiring
- Healthcare & Medical Services37
- Education1
- Insurance1
What Employers Look For
The qualifications that appear most often in transition of care jobs.
- Active RN licensure or licensed social work credential such as LCSW or LSW
- Experience with care coordination or discharge planning in an acute or post-acute setting
- Proficiency with electronic health record systems such as Epic or Cerner
- Knowledge of Medicare and Medicaid coverage criteria and post-acute placement options
- Certification in case management such as CCM or ACM preferred
- Familiarity with utilization management principles and InterQual or Milliman criteria
Tips for Your Transition Of Care Job Search
Tailor your resume to care continuum outcomes
Hiring managers for transition of care roles want to see concrete results: reduced readmissions, shorter lengths of stay, or improved post-discharge follow-up rates. Lead each bullet with the outcome, then describe the process you used to get there.
Highlight your interdisciplinary collaboration experience
Transition of care work sits at the intersection of clinical, social work, and administrative teams. Your resume should name the specific disciplines you coordinated with, such as hospitalists, social workers, or case managers, and describe what that collaboration produced.
Apply early to roles that fit
Migrate Mate lists transition of care openings from across the United States in one place, so you can find roles that match and apply directly to each listing.
Filter openings by required care settings
Transition of care jobs vary dramatically by setting. Acute-to-post-acute roles require different skills than those managing community transitions or telehealth follow-up. Filter your search by care setting so you target openings where your specific background is a direct match.
Prepare scenario answers around high-risk patient populations
Interviewers for these roles frequently ask how you handle complex discharges, patient non-compliance, or gaps in community resources. Prepare two or three specific scenarios involving high-risk patients, detailing what you assessed, who you contacted, and what the patient outcome was.
Negotiate for a realistic caseload in your offer conversation
Caseload size directly affects your ability to do transition of care work well. Ask the hiring manager what the current average caseload looks like and how it is distributed. This question signals competence and helps you evaluate whether the role is set up for success.
Transition Of Care Jobs: Frequently Asked Questions
Which companies are hiring the most transition of cares?
The companies hiring the most transition of cares right now include Molina Healthcare, CVS Health, and Beth Israel Lahey Health, with the largest share of openings in Massachusetts, Illinois, and Washington, based on current listings on Migrate Mate as of June 2026. Health systems and managed care organizations tend to post the highest volume of transition of care openings nationally.
How many transition of care jobs are remote?
About 28% of transition of care openings are fully remote or hybrid as of June 2026, reflecting growing adoption of telephonic and virtual care coordination models. Roles focused on post-discharge follow-up calls, telehealth-based care management, and insurance-side utilization review tend to be the most remote-friendly within this specialty.
How do you become a transition of care?
Most transition of care roles require a clinical or social work license, typically an RN or LCSW, along with direct patient care experience in a hospital or post-acute setting. From there, gaining exposure to discharge planning, case management, or utilization review builds the core competencies employers look for. Earning a certified case manager credential strengthens your candidacy further, and many professionals move into these roles directly from floor nursing or inpatient social work positions.
Can I get hired in transition of care with little experience?
Entry-level transition of care positions do exist, particularly at community health organizations and smaller health systems that hire newly licensed nurses or social workers and provide structured training. Emphasizing any clinical rotation, discharge planning exposure, or community resource navigation you have completed strengthens your application. Applying to coordinator-level titles rather than specialist or manager roles gives you the most realistic starting point when your experience is limited.
What does the transition of care interview process look like?
The process typically starts with a phone screen from a recruiter or HR coordinator, followed by one or two structured interviews with the hiring manager and often a clinical or operations leader. Expect scenario-based questions about managing complex discharges, navigating insurance barriers, and coordinating across care teams. Some employers include a panel interview with colleagues from social work, nursing, or utilization management, and a few acute-care health systems require a brief written or case-based assessment.
Where can I find and apply to transition of care jobs?
You can find and apply to transition of care jobs on Migrate Mate, which lists current openings from across the United States. Search the available listings to find roles that match your background, care setting preference, and location, then apply directly to each position that fits.
See All 39+ Transition Of Care Jobs
Jump back to the full list of openings and apply to any transition of care role that fits.
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