Remote Cardiac Care Navigator for CHF Support

Seamless Assist; Houston (TX); Remote; USD 60,174,000 - 68,770,000; Full time

Job summary

Seamless Assist is hiring a Remote Care Navigator for Cardiac care coordination. This full-time, non-clinical role supports medically complex patients with CHF through telephonic outreach, care plan support, and CMS-compliant documentation.

Work is 100% remote for US-based candidates, with CST/PST overlap and flexible business hours. You will collaborate with RNs and cardiology teams to reduce hospitalizations and promote patient self-management.

Qualifications

• Active MA certification or equivalent
• Minimum 2 years in care coordination or case management
• Familiar with CMS PCM/CCM/TCM program requirements and documentation
• Proficient with care coordination software or EHRs
• AI tools to improve productivity
• Based in the United States with US work authorization
• Excellent written and verbal English

Responsibilities

• Conduct structured telephonic outreach to CHF and cardiac patients
• Maintain patient caseload using risk stratification
• Complete initial assessments and follow-ups on symptoms, meds, psychosocial status, and SDOH
• Support TCM follow-up within 48 hours post-discharge
• Educate patients on CHF self-management
• Monitor for worsening conditions and escalate as needed
• Review dashboards to address care gaps
• Document time, interventions, and patient goals per CMS
• Communicate with RNs, cardiologists, and PCP offices

Skills

Care coordination

CMS PCM/CCM/TCM

EHR experience

AI tools

English fluency

US work authorization

Education

Active MA certification

Tools

EHR platforms

Care management software

Population health dashboards

CMS documentation tools

Job description

Seamless Assist is hiring a Remote Care Navigator for Cardiac care coordination. This full-time, non-clinical role supports medically complex patients with CHF through telephonic outreach, care plan support, and CMS-compliant documentation.

Work is 100% remote for US-based candidates, with CST/PST overlap and flexible business hours. You will collaborate with RNs and cardiology teams to reduce hospitalizations and promote patient self-management.