Senior Care Navigator for High-Risk Patients

CenterWell Senior Primary Care; Frankfort (KY); Hybrid; USD 54.000 - 73.000; Vollzeit

Benefits dieser Stelle

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings

Paid time off

Short-term & long-term disability

Life insurance

Zusammenfassung

CenterWell Senior Primary Care seeks a Care Coach to provide proactive, patient-centered care coordination and social support for high‑risk patients. You will be the primary contact, perform home visits, and reinforce care plans while collaborating with primary care and community resources.

The role emphasizes care transitions, patient education, and culturally competent outreach in a field-based/clinic mix. LPN/LVN or RN credentials are preferred; bilingual skills are a plus.

Qualifikationen

• 3+ years ambulatory or senior-care patient care.
• Ability to discuss chronic conditions and reinforce medication instructions.
• Comfortable conducting home visits and community outreach.
• Experience in patient education, care coordination, and social support for high‑risk or geriatric populations.

Aufgaben

• Clinical screening & escalation: conduct structured patient interviews, document findings, and share with providers.
• Outreach and home visits to assess living conditions and safety concerns.
• Social needs support by connecting patients with community resources.
• Deliver chronic disease education using approved materials to reinforce care plans.
• Coordinate care across primary care, specialists, pharmacies, and home health; support transitions and follow-ups.

Kenntnisse

Ambulatory care

Primary care

Home visits

Care coordination

Patient education

Cultural competence

Ausbildung

LPN/LVN license

RN license

Medical Assistant certification

Jobbeschreibung

CenterWell Senior Primary Care seeks a Care Coach to provide proactive, patient-centered care coordination and social support for high‑risk patients. You will be the primary contact, perform home visits, and reinforce care plans while collaborating with primary care and community resources.

The role emphasizes care transitions, patient education, and culturally competent outreach in a field-based/clinic mix. LPN/LVN or RN credentials are preferred; bilingual skills are a plus.