Care Coordinator

Care Coordinator (Medical Assistant / Community Health Worker)

Location : Remote (Monday-Friday 8am-5pm)

Reports to : Clinical Director / Supervising Nurse

Employment Type : Full-Time (Non-Exempt)

About Us

We partner exclusively with Federally Qualified Health Centers (FQHCs) to deliver outsourced care management services that blend technology with human connection. Our remote teams support chronic care management (CCM), remote patient monitoring (RPM), behavioral health integration (BHI), and advanced primary care management (APCM) programs all designed for FQHC workflows, billing, and patient needs.

We exist to reduce the burden on health center staff, expand access between visits, and improve outcomes especially for underserved communities.

Position Summary

We are hiring a Care Coordinator to support patients enrolled in chronic care programs by assisting patients with multiple chronic conditions in navigating their care. The care coordinator works closely with care managers, nurses, primary care providers and other members of the interdisciplinary team to promote patient engagement, ensure timely follow-up and connect patients to needed medical and community resources. This role focuses on patient outreach, care plan support and coordination of services to improve health outcomes and reduce avoidable hospitalizations.

This is a high-touch, relationship-driven role ideal for those passionate about engaging underserved patients in high quality care, coordinating care remotely, and improving health outcomes one call at a time!

Key Responsibilities

Patient Engagement & Support

• Perform patient intake, explain program benefits and answer questions, and enroll them into the appropriate care management services.
• Conduct frequent patient check-ins to gather health updates, reinforce care plans, address any outstanding needs and support patient understanding.
• Build rapport and trust, using clear and simple language across diverse and often underserved populations.
• Screen for outstanding health maintenance screenings, including social determinants of health (SDOH) and coordinate follow-up as needed.

Care Coordination & Team Collaboration

Documentation & Compliance

Operational Tasks

Qualifications Required

Preferred

What We Offer