Care Transition Coordinator

Sanitas; Naples (FL); On-site; USD 52,000 - 72,000; Full time

Job summary

Sanitas is seeking a Case Management Coordinator in Naples, FL, to oversee the transition of care for post‑discharge members and those with chronic conditions. You will coordinate follow-up care, create personalized care plans, and educate patients and caregivers to prevent readmissions and improve outcomes.

The ideal candidate will have MA certification, strong clinical knowledge, and experience in care coordination.

Qualifications

• Strong clinical knowledge of chronic disease management and post‑acute care processes.
• Proficient in motivational interviewing to educate and empower members and caregivers.
• Excellent communication, both verbal and written, with interdisciplinary teams and patients.

Responsibilities

• Conduct timely post-discharge outreach (within 24–72 hours) to assess needs and confirm instructions.
• Coordinate follow-up appointments and post-acute services with providers, home health, and community resources.
• Develop individualized care plans based on program categories and risk factors.
• Educate patients and caregivers on self-management and red‑flag symptoms to reduce readmissions.
• Document all interactions and interventions accurately in care management platforms/EMR.

Skills

Clinical knowledge

Patient engagement

Communication

Problem-solving

Documentation in EMR

Education

High school diploma or equivalent

Graduation from an accredited Medical Assistant (MA) program

Tools

EMR

Job description

Sanitas is seeking a Case Management Coordinator in Naples, FL, to oversee the transition of care for post‑discharge members and those with chronic conditions. You will coordinate follow-up care, create personalized care plans, and educate patients and caregivers to prevent readmissions and improve outcomes.

The ideal candidate will have MA certification, strong clinical knowledge, and experience in care coordination.