In-Home Chronic Care Specialist

Upward Health, Inc.; Aurora (IL); On-site; USD 45,000 - 65,000; Full time

Job summary

Upward Health, Inc. is seeking a Care Specialist to deliver chronic care management in patients' homes and communities, with some virtual care. You will guide enrollment, coordinate appointments, and ensure adherence to care plans to improve outcomes and reduce hospitalizations.

The role emphasizes relationship-building, care coordination, and patient education, with a focus on comprehensive, person-centered care.

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

• Deliver chronic care management to high-complexity patients in patients’ homes and communities (90%) and via virtual care (10%).
• Guide patients through enrollment, coordinate virtual appointments with providers, and ensure adherence to care plans.
• Build relationships, coordinate care, and educate patients to improve outcomes and prevent hospitalizations.

Skills

Chronic care management

Patient outreach

Motivational interviewing

Care coordination

EMR proficiency

Education

High school diploma or GED

Tools

EMR systems

Job description

Upward Health, Inc. is seeking a Care Specialist to deliver chronic care management in patients' homes and communities, with some virtual care. You will guide enrollment, coordinate appointments, and ensure adherence to care plans to improve outcomes and reduce hospitalizations.

The role emphasizes relationship-building, care coordination, and patient education, with a focus on comprehensive, person-centered care.