Post-Discharge Care Coordinator

RiseMe; Palm Harbor (FL); On-site; USD 50,000 - 70,000; Full time

Job summary

Sanitas is expanding across the United States and seeks a Case Management Coordinator to oversee transitions of care after discharge and for members with chronic conditions. You will coordinate follow-up services, develop personalized care plans, and educate patients and caregivers to prevent readmissions and improve outcomes.

The role requires MA certification, CPR/BLS, and strong knowledge of chronic disease management, with a focus on patient engagement and effective communication in a

Qualifications

• Strong knowledge of chronic disease management and post-acute care processes.
• Experience with care coordination, utilization review, or population health management in healthcare.
• Active MA national certification is required.
• CPR/BLS for Healthcare Providers is required.
• Fluent in English; bilingual in Spanish/Creole preferred.

Responsibilities

• Conduct post-discharge outreach within 24–72 hours to assess member needs and confirm understanding of instructions.
• Coordinate follow-up appointments and services with PCPs, specialists, home health, and community resources.
• Develop individualized care plans based on program categories and risk factors.
• Document assessments and interventions accurately in the care management system.

Skills

Motivational interviewing

Communication

Problem-solving

Clinical knowledge

Patient engagement

Education

High school diploma or equivalent

Graduate from a nationally accredited Medical Assistant (MA) program

Tools

EMR / Electronic Medical Records

Care management platform

Job description

Sanitas is expanding across the United States and seeks a Case Management Coordinator to oversee transitions of care after discharge and for members with chronic conditions. You will coordinate follow-up services, develop personalized care plans, and educate patients and caregivers to prevent readmissions and improve outcomes.

The role requires MA certification, CPR/BLS, and strong knowledge of chronic disease management, with a focus on patient engagement and effective communication in a