Care Specialist

About the role

The Care Specialist is a key member of the team responsible for delivering chronic care management to high-complexity patients. The role primarily works in patients' homes and communities (90% of the time) and engages in virtual care (10% of the time).

Responsibilities

• Direct outreach to patients, guiding them through the enrollment process.
• Facilitating virtual appointments with providers.
• Ensuring patients adhere to care plans.
• Building relationships, coordinating care, and providing education.
• Promoting health, preventing unnecessary hospitalizations, and improving patient outcomes.

Requirements

• Minimum of 2 years of relevant work experience (e.g., Community Health Worker, Peer Support Specialist, Medical Assistant, etc.).
• A high school diploma or GED required.
• A valid driver's license, auto liability insurance, and reliable transportation to travel within the assigned territory.
• Experience in chronic care management or working with chronically ill/elderly patients.
• Technologically proficient with basic computer skills (typing, using EMR systems).
• Experience with motivational interviewing, trauma-informed care, and care coordination.
• Strong interpersonal communication skills with the ability to engage patients and team members effectively.
• Ability to prioritize tasks, manage schedules, and work independently in an unstructured environment.
• Multi-lingual skills are a plus but not required.
• Prior home care experience is beneficial.

Key Behaviors

• Adaptability & Resilience: Ability to thrive in unstructured environments and pivot as needed to meet patient needs. Demonstrates perseverance in challenging situations.
• Self-Starter & Motivation: Proactively takes initiative in managing patient care and outreach. Willingness to learn and adapt to new processes and systems.
• Empathy & Compassion: Ability to work with individuals from diverse backgrounds and understand their complex needs. Skilled in building rapport through motivational interviewing and other patient-centered communication techniques.
• Accountability & Integrity: Demonstrates personal responsibility and takes ownership of tasks, ensuring accuracy and timeliness in all activities.
• Cultural Competence: Awareness of community dynamics and diversity, ensuring culturally sensitive and inclusive care.
• Team Collaboration: Works collaboratively with interdisciplinary teams to meet patient and organizational goals.
• Problem-Solving & Critical Thinking: Strong critical thinking skills to assess patient needs, analyze data, and develop appropriate care strategies.
• Communication Skills: Excellent verbal and written communication, capable of explaining complex medical information to patients in a clear and supportive manner.

Competencies

• Care Coordination: Ability to engage patients in a comprehensive care plan, facilitating communication between patients, providers, and family members to ensure timely, effective care.
• Health Education: Effectively educates patients about their medical conditions, care plans, and available resources, ensuring that patients can make informed decisions.
• Patient Engagement: Uses various strategies, including phone calls, home visits, and community outreach, to engage patients and ensure continuous participation in their care.
• Time Management & Organization: Demonstrates strong organizational skills by managing patient caseloads, schedules, and documentation efficiently.
• Technology Proficiency: Skilled in using electronic health records (EMR) systems and other digital tools to document patient information and communicate within the team.
• Motivational Interviewing & Patient-Centered Care: Uses motivational interviewing techniques to build rapport and empower patients to take ownership of their health decisions.
• Data Management: Ensures accurate and timely documentation of patient data, ensuring continuity of care and compliance with organizational standards.
• Outcome-Oriented Approach: Focuses on achieving key health outcomes, such as improved care adherence, reduction in emergency room visits, and enhanced self-management.

Upward Health Benefits

Upward Health is committed to offering competitive benefits to support our employees' well-being. Details will be provided upon hire.

Upward Health Core Values

At Upward Health, we believe in fostering a culture that values diversity, equity, and inclusion. Our core values guide us in creating a workplace where everyone feels valued and empowered to contribute their best work.

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