In-Home Chronic Care Navigator

Upward Health; Casa Grande (AZ); On-site; USD 42,000 - 68,000; Full time

Job summary

Upward Health is seeking a Care Specialist to deliver chronic care management primarily in patients' homes across communities in the United States. The role emphasizes coordinating care, guiding enrollment, and facilitating virtual appointments with providers to improve outcomes.

You will engage patients 90% at home and 10% virtually, build trust, educate patients, and help prevent hospitalizations through proactive care and timely communication.

Qualifications

• Minimum 2 years of relevant work experience in community health, care coordination, or related fields.
• 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 and EMR systems.
• Experience with motivational interviewing and trauma-informed care.
• Strong interpersonal communication skills for engaging patients and team members.
• 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

• Deliver chronic care management primarily in patients' homes and communities (90% home visits, 10% virtual care).
• Direct outreach to patients, guiding enrollment, and coordinating care.
• Facilitate virtual appointments with providers.
• Build relationships, educate patients, and promote adherence to care plans.
• Work to prevent unnecessary hospitalizations and improve patient outcomes.

Skills

Community Health Worker

Medical Assistant

Motivational interviewing

Trauma-informed care

Care coordination

Multilingual skills

Driver's license

EMR systems

Education

High school diploma or GED

Tools

EMR Systems

Mobile devices

Job description

Upward Health is seeking a Care Specialist to deliver chronic care management primarily in patients' homes across communities in the United States. The role emphasizes coordinating care, guiding enrollment, and facilitating virtual appointments with providers to improve outcomes.

You will engage patients 90% at home and 10% virtually, build trust, educate patients, and help prevent hospitalizations through proactive care and timely communication.