Senior Care Navigator — Field-Based Coach

CenterWell; Charlotte (NC); On-site; USD 54,000 - 73,000; Full time

Benefits offered by this job

Travel required

Competitive benefits

Job summary

CenterWell Senior Primary Care is seeking a Care Coach to provide proactive, patient-centered care coordination and social needs support for high-risk patients. You will serve as the primary contact for patients and focus on care coordination, adherence coaching, healthcare navigation, transitions of care, and reinforcing care plans.

The role coordinates care across health and social services, conducts home visits, identifies barriers to engagement, delivers education, and supports care

Qualifications

• Healthcare professional with 3+ years of ambulatory, primary care, or senior‑care experience with direct patient care.
• Ability to discuss chronic conditions and reinforce medication instructions.
• Comfortable conducting home visits and community-based outreach.
• Experience in patient education, care coordination, and social support of high‑risk populations.

Responsibilities

• Coordinate care across health and social service systems for high‑risk patients.
• Conduct structured patient interviews, assess barriers to adherence and social needs.
• Perform home visits to observe living conditions and safety concerns.
• Deliver chronic disease education using approved materials.
• Facilitate care transitions, follow-ups, and communication among providers.

Skills

Ambulatory/Primary Care experience

Care coordination

Patient education

Home visits

Education

LPN/LVN license

RN license or foreign equivalent

Job description

CenterWell Senior Primary Care is seeking a Care Coach to provide proactive, patient-centered care coordination and social needs support for high-risk patients. You will serve as the primary contact for patients and focus on care coordination, adherence coaching, healthcare navigation, transitions of care, and reinforcing care plans.

The role coordinates care across health and social services, conducts home visits, identifies barriers to engagement, delivers education, and supports care