Care Transition Navigator

Sanitas; Katy, Town of Texas (TX, WI); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Sanitas is seeking a Case Management Coordinator to manage transitions of care for members post-discharge, coordinating follow-up and education to improve health outcomes. The role emphasizes collaboration with primary care, specialists, home health, and community resources.

The ideal candidate will have MA program completion, active MA certification, CPR/BLS, and experience in clinical case management, with strong communication skills and proficiency in EMR systems.

Qualifications

• Proven knowledge of chronic disease management and post-acute care processes.
• Ability to engage patients and caregivers using motivational interviewing techniques.
• Excellent verbal and written communication with interdisciplinary teams.
• Strong clinical problem-solving skills to identify barriers to care.
• Ability to accurately document assessments and interventions in EMR/CMS platforms.

Responsibilities

• Conduct post-discharge outreach within 24–72 hours to assess needs and gaps.
• Coordinate follow-up appointments and post-acute services across care continuum.
• Develop individualized care plans based on program categories and risk factors.
• Educate members and caregivers on red-flag symptoms and self-management strategies.
• Document all interactions and interventions promptly to ensure compliance and accuracy.

Skills

Clinical knowledge

Patient engagement

Communication

Problem solving

EMR literacy

Education

High school diploma or equivalent

MA program completion

Tools

EMR systems

Care management platform

Job description

Sanitas is seeking a Case Management Coordinator to manage transitions of care for members post-discharge, coordinating follow-up and education to improve health outcomes. The role emphasizes collaboration with primary care, specialists, home health, and community resources.

The ideal candidate will have MA program completion, active MA certification, CPR/BLS, and experience in clinical case management, with strong communication skills and proficiency in EMR systems.