Post-Discharge Care Coordinator

Sanitas Medical Centers; Naples (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

Sanitas Medical Centers seeks a Case Management Coordinator to manage transitions 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.

Responsibilities include outreach within 24-72 hours, coordinating with providers and community resources, developing care plans, and documenting all activities in the care management

Responsibilities

• Conduct timely post-discharge outreach (within 24-72 hours) reviewing discharge summaries, medication lists, and follow-up recommendations.
• 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 based on program categories, identifying early signs of complications to manage chronic conditions.
• Educate members and caregivers using motivational interviewing, guiding on red-flag symptoms and self-management to reduce over-utilization.
• Document all interactions and clinical interventions in the care management platform to maintain compliance and advocate for member needs.

Job description

Sanitas Medical Centers seeks a Case Management Coordinator to manage transitions 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.

Responsibilities include outreach within 24-72 hours, coordinating with providers and community resources, developing care plans, and documenting all activities in the care management