What are the responsibilities and job description for the Transition Planner - Social Worker position at Amae Health?
Amae Health is hiring - Transforming the lives of those affected by severe mental illness
At Amae Health, we are dedicated to helping the 15.4 million Americans living with severe mental illness (SMI) lead stable, meaningful lives, while ending the cycle of repeat hospitalizations. In partnership with some of the nations top academic medical centers, we’ve pioneered an innovative outpatient care model that combines compassionate, in-person psychiatric care with comprehensive wraparound support. Our integrated care teams — including psychiatrists, therapists, primary care physicians, health coaches, and peer support specialists — work together to treat the whole person via a unique model, addressing physical, mental, and social needs in unison. By caring for every aspect of our patients’ well-being, we help them not just survive, but truly thrive.
The Opportunity
We are growing our presence in the Bay Area and are collaborating with a top academic medical center to open our first Northern California clinic. As we build out our multidisciplinary team, we are hiring a Care Transition Planner to support our patients in their transition from inpatient care to care at Amae. Reporting to the Chief Strategy Officer with a dotted line to the Clinic Director, you will work across inpatient and emergency units at collaborating acute care facilities to support patient’s transition plans, bridging the gap in patient’s care journeys and meeting patients where they are at to connect them with the care they need.
What You Will Work On
A true patient advocate, you excel in using your knowledge of San Francisco Bay Area’s health systems and services to connect patients to the most appropriate resources in order to support their care journeys. Strong communication skills and an inherent ability to build trust are your hallmarks, and you are passionate about initiating, establishing and maintaining relationships with patients and families that are founded on trust and rapport. You are adaptable, flexible and organized, people centered, and excited about the opportunity to be part of a team that is changing how SMI care is delivered in our community.
What You’ll Have
Amae Health is proud to offer a comprehensive benefits package to take care of you now and in the future, focusing on your personal, financial and professional wellness.
Base salary range for this role is $70,000 to $115,000 per year based on a full-time schedule. Actual compensation packages are based on several factors that are unique to each candidate. These factors include, but are not limited to, job related knowledge and skill set, depth of experience, certifications, degrees, licensures, and specific work location.
More About Amae
'Amae', pronounced ‘Ah-mai’, is a Japanese concept meaning the need to be in good favor with, and the ability to depend on, the people around oneself. It reflects our core belief that a strong support system is essential to build people up, strengthen their will to carry on and even to thrive in life. This mentality applies across our whole company – from the patients we serve to the team we’re building.
We’re a Public Benefit Corporation (PBC) that provides outpatient psychiatric and primary care health services through value-based care arrangements. Our model’s success is predicated upon achieving outcomes for our patients, and ensuring lasting recovery.
Amae Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.
At Amae Health, we are dedicated to helping the 15.4 million Americans living with severe mental illness (SMI) lead stable, meaningful lives, while ending the cycle of repeat hospitalizations. In partnership with some of the nations top academic medical centers, we’ve pioneered an innovative outpatient care model that combines compassionate, in-person psychiatric care with comprehensive wraparound support. Our integrated care teams — including psychiatrists, therapists, primary care physicians, health coaches, and peer support specialists — work together to treat the whole person via a unique model, addressing physical, mental, and social needs in unison. By caring for every aspect of our patients’ well-being, we help them not just survive, but truly thrive.
The Opportunity
We are growing our presence in the Bay Area and are collaborating with a top academic medical center to open our first Northern California clinic. As we build out our multidisciplinary team, we are hiring a Care Transition Planner to support our patients in their transition from inpatient care to care at Amae. Reporting to the Chief Strategy Officer with a dotted line to the Clinic Director, you will work across inpatient and emergency units at collaborating acute care facilities to support patient’s transition plans, bridging the gap in patient’s care journeys and meeting patients where they are at to connect them with the care they need.
What You Will Work On
- Represent Amae Health in the ER and inpatient hospital setting with our academic medical center partners to coordinate patient transitions to Amae, ensuring continuity of care as patients begin their care journey with Amae Health
- Support the Amae patient journey through conducting thorough patient screenings either in the hospital, the community or in the home
- Function as a patient advocate, supporting access to necessary health and social services
- Collaborate with a multidisciplinary team and establish and maintain trust and rapport with patients, families and teammates
A true patient advocate, you excel in using your knowledge of San Francisco Bay Area’s health systems and services to connect patients to the most appropriate resources in order to support their care journeys. Strong communication skills and an inherent ability to build trust are your hallmarks, and you are passionate about initiating, establishing and maintaining relationships with patients and families that are founded on trust and rapport. You are adaptable, flexible and organized, people centered, and excited about the opportunity to be part of a team that is changing how SMI care is delivered in our community.
What You’ll Have
- A Bachelor’s or Master’s degree in Social Work (BSW or MSW) is required. An active, unrestricted California license is preferred—such as a Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), or Licensed Professional Counselor (LPC).
- 1 years of patient facing experience as a social worker, discharge planner or transition planner in a hospital setting
- Knowledge of and familiarity with the mental health and social service systems in the San Francisco Bay Area and an understanding of patient rights and a holistic perspective of “health”
- Demonstrated skill and adaptability in working with people from diverse backgrounds in a variety of settings
- Comfort working one-on-one or in group settings, with experience facilitating workshops, events or activities
- Excellent communication skills and a strong desire to collaborate with others in a team based environment and community settings
- Organized with strong attention to detail and the ability to navigate and learn new technologies and platforms, familiarity with EHR systems and Google Suite desired
Amae Health is proud to offer a comprehensive benefits package to take care of you now and in the future, focusing on your personal, financial and professional wellness.
- Health Insurance: Comprehensive medical, dental & vision plans
- Employee Assistance Program
- 401(k)
- FSA & HSA savings programs
- Short & long-term disability
- Pre-tax commuter assistance program
- Paid Time Off
- Parental Leave - 12 weeks for birth and non birth parent
- 11 company holidays
Base salary range for this role is $70,000 to $115,000 per year based on a full-time schedule. Actual compensation packages are based on several factors that are unique to each candidate. These factors include, but are not limited to, job related knowledge and skill set, depth of experience, certifications, degrees, licensures, and specific work location.
More About Amae
'Amae', pronounced ‘Ah-mai’, is a Japanese concept meaning the need to be in good favor with, and the ability to depend on, the people around oneself. It reflects our core belief that a strong support system is essential to build people up, strengthen their will to carry on and even to thrive in life. This mentality applies across our whole company – from the patients we serve to the team we’re building.
We’re a Public Benefit Corporation (PBC) that provides outpatient psychiatric and primary care health services through value-based care arrangements. Our model’s success is predicated upon achieving outcomes for our patients, and ensuring lasting recovery.
Amae Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.
Salary : $70,000 - $115,000
