Remote Care Navigator

RemoteFetch; Dallas (TX); Remote; USD 29,000 - 33,000; Full time

Job summary

RemoteFetch is hiring a full-time Remote Care Navigator for Cardiac care coordination. This non-clinical, telephonic role supports medically complex CHF patients with care plan guidance, CMS-compliant documentation, and team coordination under RN supervision.

The position emphasizes remote outreach, risk-based caseload management, and collaboration with cardiology and PCP offices to reduce hospitalizations and empower patient self-management.

Qualifications

• Active MA certification or equivalent credential (CNA, EMT, CHW with relevant experience)
• Minimum 2 years in care coordination, case management, or ambulatory care
• Familiarity with CMS PCM, CCM, and/or TCM program requirements and documentation standards
• Technologically proficient with care coordination software and/or EHRs
• AI fluency - actively uses AI tools to work faster and more efficiently
• Must be based in and authorized to work in the United States - time zone compatibility (US business hours, CST/PST overlap)
• Exceptional written and verbal communication in English; strong phone presence

Responsibilities

• Conduct structured telephonic outreach to CHF and complex cardiac patients
• Maintain an assigned patient caseload using risk stratification to prioritize outreach
• Complete initial assessments and follow-ups covering symptoms, medications, psychosocial status, and SDOH barriers
• Support Transitional Care Management follow-up within 48 hours post-discharge
• Provide patient education on CHF self-management and evidence-based strategies
• Monitor for signs of worsening conditions or care gaps and escalate as needed
• Review dashboards to address care gaps (wellness visits, labs, symptom monitoring)
• Document time, interventions, care plans, and patient goals per CMS billing standards
• Maintain proactive communication with RN Care Managers, cardiologists, and PCP offices
• Note: role excludes clinical assessment, diagnosis, prescribing, and in-person visits

Skills

MA certification

Care coordination

CMS PCM/CCM/TCM

Care coordination software

AI fluency

US work authorization

English communication

Tools

EHR platforms

Care management software

Population health dashboards

CMS documentation tools

Job description

About the job Remote Care Navigator

REMOTE CARE NAVIGATOR - CARDIAC

Sector

Healthcare - Cardiac Care Coordination

Reports To

RN Care Manager / Clinical Supervisor

Type

Full-Time 40 hours/week

Schedule

Monday-Friday Weekends - Flexible business hours (US hours, CST/PST overlap required)

Rate

$21-$24 USD/hour (based on experience)

Contract

W-2

Location

100% Remote - US only (Dallas/Fort Worth area preferred)

Tools

EHR platforms, care management software, population health dashboards, CMS documentation tools

Role Overview

Our client - a cardiac care management MSO - is hiring full-time virtual Care Navigators to support a growing population of medically complex patients with cardiac conditions, primarily congestive heart failure (CHF). This is a non-clinical (non-licensed) role focused on telephonic patient outreach, care plan support, CMS-compliant documentation, and coordination across the care team. The Care Navigator works under the supervision of RN Care Managers, escalating all clinical concerns appropriately. This role plays a critical part in reducing avoidable hospitalizations and supporting patient self-management over the long term.

Key Responsibilities

• Conduct structured telephonic outreach to CHF and complex cardiac patients
• Maintain an assigned patient caseload using risk stratification to prioritize outreach
• Complete initial assessments and follow-ups covering symptoms, medications, psychosocial status, and SDOH barriers
• Support Transitional Care Management (TCM) follow-up within 48 hours post-discharge - medication reconciliation, red-flag symptom screening, appointment scheduling
• Provide patient education on CHF self-management and evidence-based strategies
• Monitor for signs of worsening conditions or care gaps and elevate to supervising RN
• Review and act on population health dashboards to address care gaps (wellness visits, labs, symptom monitoring)
• Document time, interventions, care plans, and patient goals per CMS billing standards
• Maintain proactive communication with RN Care Managers, cardiologists, and PCP offices
• Clinical assessment or medical diagnosis
• Medication prescribing or adjustments
• Interpretation of labs, imaging, or EKGs
• Clinical triage or emergency response
• In-person or home visit patient contact
• Billing or coding beyond required time-based documentation

Scope Limitations - This Role Does NOT Include

• Clinical assessment or medical diagnosis
• Medication prescribing or adjustments
• Interpretation of labs, imaging, or EKGs
• Clinical triage or emergency response
• In-person or home visit patient contact
• Billing or coding beyond required time-based documentation

Experience & Skills

Required:

• Active Medical Assistant (MA) certification or equivalent clinical credential (CNA, EMT, CHW with relevant experience)
• Minimum 2 years of experience in care coordination, case management, or ambulatory care
• Familiarity with CMS PCM, CCM, and/or TCM program requirements and documentation standards
• Technologically proficient with care coordination software and/or EHRs
• AI fluency - actively uses AI tools to work faster and more efficiently.
• Must be based in and authorized to work in the United States - time zone compatibility required (US business hours, CST/PST overlap)
• Exceptional written and verbal communication in English; strong phone presence assessed at screening

Preferred:

• Knowledge of cardiac conditions - especially heart failure and associated comorbidities
• Bilingual - Spanish/English (not a must)