$50K - 70K a year
Manage referral intake and data coordination for care transitions, including screening, assigning cases, data entry, reporting, and ensuring compliance with healthcare program standards.
High school diploma plus 5 years healthcare or Medicaid-related experience with 2 years data-intensive work, preferred degree in health/business, and familiarity with care management platforms and data analytics.
Competitive Compensation & Benefits Package! Position eligible for – * Annual incentive bonus plan * Medical, dental, and vision insurance with low deductible/low cost health plan * Generous vacation and sick time accrual * 12 paid holidays * State Retirement (pension plan) * 401(k) Plan with employer match * Company paid life and disability insurance * Wellness Programs * Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Remote Option; Available for any of Partners' NC locations (or within 40 miles of NC border) Closing Date: Open Until Filled Primary Purpose of Position: The Intake and Data Specialist: Transitions Health Management serves as the operational and analytical backbone of the Care Transitions Team (CTT). This dual-function role manages all referral intake and data coordination processes for members transitioning between care settings. Responsibilities include referral screening, caseload assignment, intake documentation, data compilation, and reporting to ensure timely, accurate, and compliant transitions in alignment with the NC Tailored Care Management (TCM) Provider Manual. The position bridges front-end coordination with back-end analytics, supporting both immediate care transition operations and long-term program evaluation for quality improvement. Role and Responsibilities: Referral and Intake Management * Manage the CTT_InpatientED_Referrals email inbox and process all incoming referrals from ADT feeds, UM notifications, census reports, NC HealthConnex, and hospital/facility liaisons. * Screen referrals for program eligibility (Medicaid/Tailored Plan status, qualifying transition setting, etc.). * Assign cases daily to Care Transitions Care Managers based on acuity, facility location, and team workload. * Enter referral and intake data accurately in TruCare within established timeframes (24 hours of receipt). * Conduct intake calls with hospital staff, members, or caregivers to explain the Care Transitions process, obtain consent, and gather baseline data. Data Management, Reporting, and Analytics: * Compile, analyze, and present Care Transitions data from multiple systems (TruCare, Jasper, HBI, Report Manager, Relias). * Design and maintain dashboards, daily intake reports, and caseload tracking tools for leadership review. * Extract and analyze trends related to hospital readmissions, ED utilization, and follow-up compliance to inform population health strategy. * Prepare and validate data for State, CMS, and internal reports related to TCM and transition performance metrics. * Collaborate with Population Health and Data Analytics teams to evaluate program effectiveness, ROI, and quality metrics. * Serve as a TruCare subject matter expert (SME) to support operational enhancements, data integrity, and user training. Coordination and Communication: * Notify PCPs, Tailored Care Managers, and LTSS providers within 72 hours of referral to ensure care continuity. * Support the CTT by scheduling follow-up appointments, assisting with transportation coordination, and ensuring HEDIS/quality measures are met. * Maintain communication with the CTT to verify discharge readiness and SDOH needs. * Collaborate cross-departmentally with Utilization Management, Member Engagement, and Population Health teams to align efforts. Documentation and Compliance: * Maintain complete and accurate records of all referrals, intake actions, assignments, and follow-up documentation in TruCare. * Ensure compliance with the NC TCM Provider Manual standards for contact timeliness, reassessment, and documentation. * Participate in internal audits, performance reviews, and process improvement initiatives. * Adhere to HIPAA and Partners Health Management data privacy and security policies. Knowledge, Skills and Abilities: * Documentation and Compliance * Maintain complete and accurate records of all referrals, intake actions, assignments, and follow-up documentation in TruCare. * Ensure compliance with the NC TCM Provider Manual standards for contact timeliness, reassessment, and documentation. * Participate in internal audits, performance reviews, and process improvement initiatives. * Adhere to HIPAA and Partners Health Management data privacy and security policies Performance Metrics * 100% of referrals screened and entered within 24 hours. * Compliance with 48-hour post-discharge contact requirement. * Accuracy of data entry and reporting in TruCare and analytics systems. * Reduction in unplanned readmissions and improved follow-up rates. * Completion of monthly reporting deliverables by assigned deadlines. Education/Experience Required: High school diploma or equivalent and at least five (5) years of healthcare, behavioral health, or Medicaid-related experience, including two (2) years of data-intensive or analytical work. Education/Experience Preferred: * Associate’s or Bachelor’s degree in health, human services, business, or related field. * Experience as a Qualified Professional (QP) within behavioral health, I/DD, or care management. * Experience using TruCare or similar care management platforms. * Experience managing data and report development. Licensure/Certification Requirements: None required; data and program management certification preferred (e.g., Excel Advanced, Power BI, or Health Data Analytics). Other requirements: • Must reside in North Carolina. • Must have ability to travel as needed to perform the job duties and participate in team meetings
This job posting was last updated on 10/18/2025