Job Details

Company Overview:

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our dedicated clinical team addresses physical, behavioral, and social health needs right where patients need support. From our doctors and nurses to our Care Specialists and administrative staff, every team member is committed to enhancing the health and lives of our patients. With comprehensive services, including management of chronic conditions and access to medically tailored meals, it's no surprise that 98% of our patients report full satisfaction with Upward Health!

Job Title & Role Description:

The Patient Care Specialist is an essential member of our healthcare team responsible for providing chronic care management to patients with high complexity. This role primarily involves working directly in the community and patients' homes (90% of the time) and engaging in virtual care (10% of the time). Key responsibilities include reaching out to patients, guiding them through the enrollment process, facilitating virtual appointments, and ensuring adherence to care plans. The Patient Care Specialist builds strong relationships, coordinates care, and empowers patients through education, playing a vital role in improving health outcomes and reducing unnecessary hospitalizations.

Skills Required:

• Minimum of 2 years of relevant experience in roles such as Community Health Worker, Peer Support Specialist, or Medical Assistant.
• High school diploma or GED is required.
• A valid driver's license, auto liability insurance, and reliable transportation are needed for travel within the assigned territory.
• Experience in chronic care management or working with elderly or chronically ill patients.
• Basic computer skills and proficiency in using electronic medical records (EMR) systems.
• Knowledge of motivational interviewing, trauma-informed care, and care coordination.
• Excellent interpersonal communication skills for effective engagement with patients and colleagues.
• Ability to prioritize and manage tasks independently within an unstructured environment.
• Multi-lingual skills are an advantage but not mandatory.
• Prior experience in home care is beneficial.

Key Behaviors:

Adaptability & Resilience:

• Thrives in unstructured environments and is adaptable to changing patient needs; exhibits perseverance in facing challenges.

Self-Starter & Motivation:

• Takes proactive initiative in patient care and outreach; openness to learning and adapting to new systems.

Empathy & Compassion:

• Understands complex needs of diverse individuals and builds rapport using motivational interviewing techniques.

Accountability & Integrity:

• Takes personal responsibility and ownership of tasks, ensuring timely and accurate completion.

Cultural Competence:

• Possesses awareness of community diversity and aims for culturally sensitive care.

Team Collaboration:

• Collaborates effectively with interdisciplinary teams to meet both patient and organizational goals.

Problem-Solving & Critical Thinking:

• Engages in critical thinking to assess patient needs, analyze data, and create effective care strategies.

Communication Skills:

• Displays excellent verbal and written communication skills, capable of clarifying complex medical information to patients in an accessible and supportive way.

Competencies:

Care Coordination:

• Engages patients in comprehensive care planning to ensure efficient communication between patients, providers, and family members.

Health Education:

• Educates patients about their conditions and care plans, empowering them to make informed health decisions.

Patient Engagement:

• Utilizes various outreach strategies, including home visits and phone calls, to keep patients engaged in their care process.

Time Management & Organization:

• Exhibits strong organizational skills to efficiently manage patient caseloads and documentation.

Technology Proficiency:

• Competent in using electronic health record systems and digital tools for documentation and communication.

Motivational Interviewing & Patient-Centered Care:

• Applies motivational interviewing techniques to foster rapport and encourage patients to take control of their health.

Data Management:

• Ensures up-to-date and accurate patient data documentation, maintaining continuity and compliance with organizational standards.

Outcome-Oriented Approach:

• Focused on achieving positive health outcomes, including better adherence to care plans and reduced emergency visits.

Upward Health is proud to be an equal opportunity employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. This job description serves as a general outline of responsibilities and is not intended to cover all duties performed within the position.

California pay range: $24 - $26 USD