Post-Discharge Care Navigator

OnDemand Visit; Phoenix (AZ); On-site; USD 38,000 - 52,000; Full time

Job summary

OnDemand Visit in Phoenix, AZ is seeking a Community Health Worker to provide care coordination and patient support after hospital discharge or field visits. The CHW focuses on follow up communication, medication access confirmation, appointment completion, and addressing resource needs.

This role requires documenting communications, coordinating with NPs, EMTs, and social workers, and managing an active caseload with timely task completion to support patient stability.

Qualifications

• Experience as a CHW, care coordinator, or patient engagement specialist preferred.
• Experience supporting patients with chronic conditions preferred.
• Strong communication and organizational skills.
• Ability to work across multiple disciplines to support patient needs.

Responsibilities

• Conduct follow up calls after clinical or field visits
• Confirm medication pickup, appointment attendance, and outstanding needs
• Resolve non clinical SDOH tasks and coordinate community resources
• Document all communication and task completion
• Maintain ongoing communication with the NP, EMTs, and Social Workers
• Manage an active caseload and complete all tasks within required timeframes
• Support patient stability through proactive follow up

Skills

Communication

Organizational skills

Multidisciplinary collaboration

Job description

OnDemand Visit in Phoenix, AZ is seeking a Community Health Worker to provide care coordination and patient support after hospital discharge or field visits. The CHW focuses on follow up communication, medication access confirmation, appointment completion, and addressing resource needs.

This role requires documenting communications, coordinating with NPs, EMTs, and social workers, and managing an active caseload with timely task completion to support patient stability.