Field-Based Care Coach & Senior Care Navigator

CenterWell; Florida; On-site; USD 54,000 - 73,000; Full time

Benefits offered by this job

Sign-on Bonus

Job summary

CenterWell Conviva Senior Primary Care, part of Humana, is seeking a Care Coach to provide proactive, patient-centered care coordination and social needs support for high-risk patients across home and clinic settings.

The role involves clinical screening, outreach, home visits, chronic disease education, and coordinating with primary care teams to ensure safe transitions; travel to patients' homes is required; 40-hour week with a $2,500 sign-on bonus.

Qualifications

• Healthcare professional with 3+ years of ambulatory or primary care experience and direct patient care.
• Ability to discuss chronic conditions and reinforce medication instructions.
• Comfort with home visits and community outreach.
• Experience in patient education and care coordination for high-risk populations.

Responsibilities

• Coordinate care across health and social service systems, acting as patient advocate and clinical support.
• Conduct structured patient interviews and collect health information; document and share findings with providers.
• Perform home visits to observe living conditions and assess safety and environmental factors.
• Identify barriers to care and connect patients with community resources.
• Deliver chronic disease education using approved materials.
• Serve as liaison among patients, primary care, specialists, pharmacies, home health, and community providers.
• Support care transitions and follow up after hospitalizations or ED visits.
• Encourage engagement with community programs and provide culturally sensitive care.

Skills

Care coordination

Adherence coaching

Social needs support

Healthcare navigation

Care transitions

Patient education

Job description

CenterWell Conviva Senior Primary Care, part of Humana, is seeking a Care Coach to provide proactive, patient-centered care coordination and social needs support for high-risk patients across home and clinic settings.

The role involves clinical screening, outreach, home visits, chronic disease education, and coordinating with primary care teams to ensure safe transitions; travel to patients' homes is required; 40-hour week with a $2,500 sign-on bonus.