In-Home Chronic Care Navigator

Upward Health; New York (NY); On-site; USD 29,000 - 33,000; Full time

Job summary

Upward Health is seeking a Care Specialist to provide in-home chronic care management for high-complexity patients, primarily visiting patients in their homes and engaging in some virtual care. You will enroll patients, coordinate appointments, and ensure adherence to care plans.

Ideal candidates bring 2+ years of related experience, a high school diploma or GED, and a valid driver's license with reliable transportation for territory travel.

Qualifications

• Minimum of 2 years of relevant work experience (e.g., Community Health Worker, Peer Support Specialist, Medical Assistant).
• 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.

Responsibilities

• Deliver chronic care management to high-complexity patients, primarily in patients\' homes (90%) with some virtual care (10%).
• Guide patients through enrollment, coordinate virtual appointments, and ensure adherence to care plans.
• Build relationships and educate patients to promote health, prevent hospitalizations, and improve outcomes.
• Collaborate with interdisciplinary teams to meet patient and organizational goals.

Skills

Community Health Worker

Peer Support Specialist

Medical Assistant

Chronic care management

Motivational interviewing

Care coordination

EMR systems

Multilingual skills

Education

High school diploma or GED

Tools

EMR systems

Job description

Upward Health is seeking a Care Specialist to provide in-home chronic care management for high-complexity patients, primarily visiting patients in their homes and engaging in some virtual care. You will enroll patients, coordinate appointments, and ensure adherence to care plans.

Ideal candidates bring 2+ years of related experience, a high school diploma or GED, and a valid driver's license with reliable transportation for territory travel.