Case Management Coordinator - Transitions of Care
Listed on 2026-09-13
-
Healthcare
Community Health, Patient/Health Advocate, Health Education & Promotion, Healthcare Administration
Job Summary
Case Management Coordinator – Transitions of Care plays a vital role in managing patients who frequently use the emergency room or are transitioning from inpatient facilities. This position supports value-based care goals by facilitating timely follow-up, reducing unnecessary utilization, and connecting patients with appropriate Sanitas and community-based resources. The role bridges care between hospital settings, primary care, and community services to improve patient outcomes and satisfaction.
Job SummaryCase Management Coordinator – Transitions of Care plays a vital role in managing patients who frequently use the emergency room or are transitioning from inpatient facilities. This position supports value-based care goals by facilitating timely follow-up, reducing unnecessary utilization, and connecting patients with appropriate Sanitas and community-based resources. The role bridges care between hospital settings, primary care, and community services to improve patient outcomes and satisfaction.
EssentialJob Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Identify and engage patients with high ER utilization or recent hospital discharges.
- Coordinate and confirm timely post-ER or post-discharge follow-up appointments.
- Educate patients on appropriate care settings and how to navigate available Sanitas services.
- Work closely with PCPs, hospital staff, and payors to create and follow through on care plans.
- Address barriers to care such as transportation, medication access, or lack of support at home.
- Document care plans, patient interactions, and interventions in the EMR.
- Track patient outcomes and contribute to performance improvement initiatives.
- Provide culturally and linguistically appropriate education to patients and caregivers.
- Encourage patient engagement and build rapport through consistent communication.
This position has no supervisory responsibilities
Required EducationHigh school graduate or equivalent.
Required Experience- 3–5 years of experience in a clinical or community health setting.
- Experience in care coordination, discharge planning, or case management
(If this job is in fact in your jurisdiction, then you may be using a Proxy or VPN to access this site, and to progress further, you should change your connectivity to another mobile device or PC).