Case Management Coordinator

Sanitas Medical Centers; Katy (TX); On-site; USD 58,000 - 78,000; Full time

Job summary

Sanitas Medical Centers in Katy, TX, is seeking a Case Management Coordinator to oversee 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.

You will collaborate with primary care providers, specialists, home health agencies, and community resources to ensure seamless continuity of care.

Qualifications

• Experience in care coordination and transition of care.
• Ability to coordinate with multiple care providers and services.
• Strong communication and patient education skills.
• Proficiency with motivational interviewing techniques.
• Experience documenting in care management systems.

Responsibilities

• Conduct timely post-discharge outreach (within 24-72 hours) to assess member needs and identify gaps in care.
• Coordinate follow-up appointments and post-acute services with providers and home health agencies to ensure continuity.
• Develop individualized care plans and identify early signs of complications to manage chronic conditions.
• Educate members and caregivers using motivational interviewing to reduce unnecessary utilization.
• Document interactions and interventions in the care management platform to ensure compliance and advocacy.

Skills

Care coordination

Discharge planning

Motivational interviewing

Patient education

Documentation

Tools

Care management platform

Job description

“Sanitas is a global healthcare organization expanding across the United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness.”
Job Summary
The Case Management Coordinator manages the transition of care for members post-discharge and those with chronic conditions, coordinating follow-up care, creating personalized care plans, and educating patients and caregivers, to prevent hospital readmissions, reduce over-utilization, and improve overall health outcomes.
Essential Job Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Conduct timely post-discharge outreach (within 24-72 hours), reviewing discharge summaries, medication lists, and follow-up recommendations, to assess member needs, confirm understanding of medical instructions, and identify immediate gaps in care.
• Coordinate follow-up appointments and post-acute services, collaborating with primary care providers, specialists, home health agencies, and community resources, to ensure seamless continuity of care across the continuum.
• Develop and implement individualized care plans based on assigned program categories, identifying early signs of complications or risk factors, to manage chronic conditions effectively and elevate clinical issues appropriately.
• Educate members and caregivers using motivational interviewing techniques, providing guidance on red-flag symptoms and self-management strategies, to empower patients and reduce patterns of over-utilization (e.g., frequent ED visits).
• Document all interactions, assessments, and clinical interventions in the care management platform accurately and timely, to maintain compliance with organizational policies, advocate for member needs, and ensure alignment with clinical guidelines.