Care Transitions & Chronic Care Coordinator

Sanitas Medical Centers; Miami (FL); On-site; USD 52,000 - 76,000; Full time

Job summary

Sanitas Medical Centers is seeking a Case Management Coordinator to oversee the transition of care for members after discharge and for those with chronic conditions. You will coordinate follow-up care, create personalized care plans, and educate patients and caregivers to prevent readmissions.

You will collaborate with primary care providers, specialists, home health agencies, and community resources, document all interactions, and ensure adherence to clinical guidelines and organizational

Qualifications

• Experience in case management or care transitions.
• Ability to develop individualized care plans.
• Proficiency in educating patients and caregivers.
• Skills in motivational interviewing.

Responsibilities

• Conduct post-discharge outreach within 24-72 hours to assess needs.
• Coordinate follow-up appointments and post-acute services.
• Develop and implement individualized care plans for chronic conditions.
• Educate members and caregivers on red-flag symptoms and self-management.
• Document interactions in the care management platform to ensure compliance.

Skills

Care coordination

Post-discharge outreach

Chronic disease management

Motivational interviewing

Patient education

Documentation

Collaboration with providers

Relationship building

Job description

Sanitas Medical Centers is seeking a Case Management Coordinator to oversee the transition of care for members after discharge and for those with chronic conditions. You will coordinate follow-up care, create personalized care plans, and educate patients and caregivers to prevent readmissions.

You will collaborate with primary care providers, specialists, home health agencies, and community resources, document all interactions, and ensure adherence to clinical guidelines and organizational