Care Transition Specialist

Sanitas Medical Centers; Plantation (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

Sanitas Medical Centers is seeking a Case Management Coordinator to oversee the transition of care for members post-discharge 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 health outcomes.

The role involves collaborating with primary care providers, specialists, home health agencies, and community resources to ensure seamless continuity of care across the care

Responsibilities

• Document all interactions, assessments, and clinical interventions in the care management platform accurately and timely.
• Coordinate follow-up appointments and post-acute services with primary care providers, specialists, home health agencies, and community resources.
• Develop and implement individualized care plans for chronic conditions and transition of care after discharge.
• Educate members and caregivers using motivational interviewing techniques to empower patients.
• Identify gaps in care and opportunities to prevent hospital readmissions and reduce over-utilization.

Skills

Care coordination

Discharge planning

Patient education

Job description

Sanitas Medical Centers is seeking a Case Management Coordinator to oversee the transition of care for members post-discharge 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 health outcomes.

The role involves collaborating with primary care providers, specialists, home health agencies, and community resources to ensure seamless continuity of care across the care