Home-Based Chronic Care Navigator

Upward Health, Inc.; Cicero (IL); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Upward Health is seeking a Care Specialist to deliver chronic care management primarily in patients' homes with some virtual care. You will outreach to patients, guide enrollment, facilitate virtual visits, and ensure adherence to care plans.

The role emphasizes building relationships, coordinating care, and educating patients to improve outcomes and reduce hospitalizations, with emphasis on compassionate, patient-centered service.

Qualifications

• Minimum of 2 years of relevant work experience (e.g., Community Health Worker, Peer Support Specialist, Medical Assistant, etc.).
• High school diploma or GED required.
• A valid driver’s license, auto liability insurance, and reliable transportation to travel within the assigned territory.
• Experience in chronic care management or working with chronically ill/elderly patients.
• Technologically proficient with basic computer skills (typing, using EMR systems).
• Experience with motivational interviewing, trauma-informed care, and care coordination.
• Strong interpersonal communication skills with the ability to engage patients and team members effectively.
• Ability to prioritize tasks, manage schedules, and work independently in an unstructured environment.
• Multi-lingual skills are a plus but not required.
• Prior home care experience is beneficial.

Responsibilities

• The Care Specialist is a key team member delivering chronic care management to high-complexity patients.
• Works primarily in patients' homes and communities (90%) and engages in virtual care (10%).
• Outreaches to patients, guides enrollment, facilitates virtual appointments, and ensures adherence to care plans.
• Builds relationships, coordinates care, and provides education to promote health and prevent hospitalizations.

Skills

2+ years experience

High school diploma

Driver’s license

Chronic care management

EMR systems

Motivational interviewing

Trauma-informed care

Care coordination

Interpersonal communication

Time management

Independent work

Multi-lingual a plus

Home care experience

Education

High school diploma or GED

Tools

EMR systems

Job description

Upward Health is seeking a Care Specialist to deliver chronic care management primarily in patients' homes with some virtual care. You will outreach to patients, guide enrollment, facilitate virtual visits, and ensure adherence to care plans.

The role emphasizes building relationships, coordinating care, and educating patients to improve outcomes and reduce hospitalizations, with emphasis on compassionate, patient-centered service.