Sanitas is a global healthcare organization expanding across 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.

Essential Job Functions

1. Clinical Data Analysis functions:
   • Obtain and analyze monthly and yearly reports and statistical data related to high utilization of healthcare services (Emergency Room visits, In-Patient, High Risk Population and other programs).
   • Share the statistical data and tendencies to the Utilization Review Staff, and to the Medical directors and other clinical staff members if is needed.
   • Perform other data analysis as requested by the utilization review staff.
2. Patient and Customer Management functions:
   • Lead the Care Coordinators and supervision of their activities as engaging and attracting patients, solving problems and working as a team with the rest of the staff to provide the best customer service possible.
   • Lead and improve the process of orienting and educating patients and their families by meeting them; explaining the role of the patient care coordinator; initiating the care plan; providing educational information in conjunction with direct care providers related to treatments, procedures, medications, and continuing care requirements.
   • Monitor the delivery of care by the Care Coordinators; identifying progress toward desired care outcomes; intervening to overcome deviations in the expected plan of care; reviewing the care plan provided to the patients by the Care Coordinator in conjunction with the direct care providers; interacting with involved departments to negotiate and expedite scheduling and completion of tests, procedures, office visits and consultations; reporting personnel and performance issues to the unit manager; maintaining ongoing communication with utilization review staff regarding variances from the care plan or transfer/discharge plan.
   • Strengthen the team knowledge respecting patients by recognizing their rights; maintaining confidentiality.
3. Insurance and Company's partnerships functions:
   • Work closely with the Insurance Company to improve the patient care given by the Care Coordinators and other clinical staff members.
   • Create and analyze statistical data to be shared with the health insurance company.
   • Liaison between the insurance company and Sanitas to improve patient flow through the system

Supervisory Responsibilities

1. Supervision of the development of interdisciplinary care plan and other case management tools by participating in meetings; coordinating information and care requirements with other care providers resolving issues that could affect smooth care progression; fostering peer support; providing education to others regarding the case management process.
2. Evaluation of the outcomes of care with the interdisciplinary team by measuring intervention effectiveness with the team; implementing team recommendations.
3. Lead the maintenance of quality service by establishing and enforcing organization standards.
4. Revision of the patient care database, checking information as it becomes available; verifying findings and reports; backing up data.
5. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies.
6. Contributes to team effort by accomplishing related results as needed
7. Ensures the permanent update of Date Bases, to improve patient care and treatments.
8. Encourage the Care Coordinators to ensure continuity of care to patients

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job the employee is regularly required to work standing up, walk, use hands to operate tools and equipment and must be able to exert regularly up to 10 pounds of force, frequently exert 30 pounds of force and occasionally exert 50 pounds of force to constantly perform the essential job functions. The employee will be frequently required to reach with hands and arms, bend, balance, kneel, crouch, crawl, push, and pull. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus. The employee is subject to environmental conditions; protection from weather conditions but not necessarily from temperature changes. The worker is subject to noise; there may be sufficient noise to cause the worker to shout in order to be heard above ambient noise level.

Required Education and Experience

1. 3-5 years experience in clinical or community resource settings; Care coordination and/or case management experience is desirable.
2. Evidence of advance leadership, communication, education, and counseling skills
3. Proficiency in communication technologies (email, cell phone, etc.)
4. Highly organized with ability to keep accurate notes and records
5. Experience with health IT systems and reports is desirable
6. Local knowledge about and connections to community health care and social welfare resources are desirable
7. Ability to speak a Spanish and English fluently

Preferred Education and Experience     

1. BA/BS Degree
2. Relevant or any other job-related vocational coursework.