In-Home Chronic Care Specialist

The Blue Venture Fund; Phoenix (AZ); On-site; USD 29,000 - 33,000; Full time

Job summary

Upward Health in Phoenix seeks a Care Specialist to deliver chronic care management to high‑complexity patients. The role is primarily in patients' homes (90%) with occasional virtual visits (10%), guiding enrollment and coordinating care with providers.

You will build relationships, educate patients, promote adherence to care plans, and work to prevent unnecessary hospitalizations while improving outcomes.

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.
• Work primarily in patients' homes; 90% of the time and engages in virtual care (10%).
• Guide enrollment, facilitate virtual appointments with providers, and ensure adherence to care plans.
• Build relationships, coordinate care, and provide education to promote health and prevent hospitalizations.

Skills

Community Health Worker

Medical Assistant

Interpersonal communication

Motivational interviewing

Trauma-informed care

Care coordination

EMR systems

Home care

Education

High school diploma or GED

Tools

EMR systems

Job description

Upward Health in Phoenix seeks a Care Specialist to deliver chronic care management to high‑complexity patients. The role is primarily in patients' homes (90%) with occasional virtual visits (10%), guiding enrollment and coordinating care with providers.

You will build relationships, educate patients, promote adherence to care plans, and work to prevent unnecessary hospitalizations while improving outcomes.