Case Management RN (68014)
On-siteDoral, Florida, United States
Job Summary
Conduct timely post-discharge outreach within 24-72 hours by reviewing discharge summaries, medication lists, and follow-up recommendations to assess member needs and identify care gaps. Coordinate follow-up appointments and post-acute services with primary care providers, specialists, and community resources to ensure seamless continuity of care. Develop and implement individualized care plans for chronic conditions, escalating clinical issues appropriately while educating members and caregivers using motivational interviewing techniques to prevent readmissions and reduce over-utilization. Document all interactions, assessments, and clinical interventions accurately in the care management platform to maintain compliance and advocate for member needs. This role supports Sanitas' mission to improve overall health outcomes through compassionate, personalized care coordination.
Required Qualifications
- Degree in Nursing (ASN or BSN), Social Work (BSW or MSW)
- Proven experience in clinical case management, care coordination, utilization review, or population health management within a healthcare setting
- Active, unrestricted clinical license as a Registered Nurse (RN), Licensed Practical Nurse (LPN), Clinical Social Worker
- Strong, demonstrated understanding of chronic disease management, evidence-based medical guidelines, and post-acute care processes
- Proficiency in motivational interviewing techniques to effectively educate and empower members and their caregivers
- Excellent verbal and written communication skills to interact effectively with patients, interdisciplinary care teams, and community partners
- Strong critical thinking and clinical problem-solving skills to identify barriers to care, risk factors for readmission, and appropriate transition plans
- Ability to accurately and timely document assessments and interventions in care management platforms or Electronic Medical Records (EMR)
- Advanced English is required
Desired Qualifications
- Certified Case Manager (CCM) credential or similar certification in care coordination/utilization review
- Bilingual (English and Spanish) to effectively serve diverse member populations
- Bilingual Spanish/Creole is preferred
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