Care Coordinator - Chronic Management

Optima Medical is an Arizona-based medical group with 30 locations and over 130 medical providers serving more than 200,000 patients statewide. Our mission is to improve quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, focusing on preventing leading causes of death. We offer a full spectrum of services including cardiovascular health, behavioral health, allergy testing, in-house lab testing, imaging, chronic disease management, and other specialty services.

About the Role

This is an in-office phone and EMR-based coordination role—not a traditional clinical floor position. As a Care Coordinator in our growing Chronic Care Management (CCM) program, you'll work directly with patients living with chronic conditions such as diabetes, hypertension, COPD, and heart disease. You'll help them stay on track with their care plans and health goals through regular outreach and follow-up. This is an excellent opportunity for Medical Assistants looking to advance their careers while using their clinical knowledge daily.

Responsibilities

• Develop personalized care plans in collaboration with patients, caregivers, and healthcare providers.
• Coordinate and facilitate communication between healthcare team members, including physicians, specialists, nurses, and ancillary service providers.
• Monitor patients' adherence to treatment plans and medications, as well as their progress toward health goals.
• Provide ongoing education and support to patients and families regarding disease management, lifestyle modifications, and preventive care.
• Utilize electronic health records (EHR) and other healthcare technology tools to document patient encounters, track interventions, and ensure continuity of care.
• Collaborate with community resources and social services agencies to address patients' social determinants of health and support overall well-being.
• Conduct regular follow-up check-ins and care coordination activities to optimize health outcomes and quality of life for patients with chronic conditions.

Qualifications

• At least 1 year of clinical work experience as a Medical Assistant.
• At least 1 year of EMR experience; eClinicalWorks preferred.
• High level of professionalism and strong customer service skills.
• Excellent written and verbal communication skills.
• Medical Assistant Course Completion Diploma or CMA designation required.
• Bilingual (English/Spanish) is a plus.
• High school diploma or GED equivalent.

Benefits

• Medical, vision, and dental insurance.
• 401(k) retirement plan.
• Paid holidays.
• Substantial growth opportunities with leadership and mentoring.
• Resources to further your career.
• Fun work environment with events and holiday parties.
• Supportive and positive work culture.