Remote Cardiac Care Navigator – Cardiac Care Coordination

Seamlessassist; Tulsa (OK); Remote; USD 29,000 - 33,000; Full time

Job summary

Seamlessassist is seeking a Remote Care Navigator (Cardiac) to support medically complex patients with heart failure. This full-time, remote role works under RN supervision and focuses on telephonic outreach, care plan support, CMS documentation, and cross-team coordination.

You will manage CHF patient outreach, document care plans, and help reduce avoidable hospitalizations while promoting patient self-management. US-based applicants preferred; CST/PST overlap required.

Qualifications

• Active MA certification or LVN/LPN license.
• Minimum 2 years of care coordination or ambulatory care experience.
• Familiarity with CMS PCM, CCM, and/or TCM program requirements and documentation standards.
• Technologically proficient with care coordination software and/or EHRs.
• AI fluency and use of AI tools to improve efficiency.
• Must be based in and authorized to work in the United States with US time-zone overlap (CST/PST).
• Excellent written and verbal communication in English.

Responsibilities

• Conduct structured telephonic outreach to CHF and complex cardiac patients.
• Maintain assigned patient caseload using risk stratification.
• Complete initial assessments and follow-ups on symptoms, medications, psychosocial status, and SDOH barriers.
• Support TCM follow-up within 48 hours post-discharge with medication reconciliation and scheduling.
• Provide patient education on CHF self-management and evidence-based strategies.
• Monitor for worsening conditions and escalate to supervising RN.
• Document interventions and care plans per CMS billing standards.
• Maintain proactive communication with RNs, cardiologists, and PCP offices.

Skills

Care coordination experience

CMS PCM/CCM/TCM knowledge

EHR proficiency

AI fluency

US work authorization

Education

MA certification or LVN/LPN license

Tools

Care coordination software

EHR systems

Job description

Seamlessassist is seeking a Remote Care Navigator (Cardiac) to support medically complex patients with heart failure. This full-time, remote role works under RN supervision and focuses on telephonic outreach, care plan support, CMS documentation, and cross-team coordination.

You will manage CHF patient outreach, document care plans, and help reduce avoidable hospitalizations while promoting patient self-management. US-based applicants preferred; CST/PST overlap required.