Remote Care Navigator

Remote Care Navigator CardiacOur client a cardiac care management MSO is hiring full-time virtual Care Navigators to support a growing population of medically complex patients with cardiac conditions, primarily congestive heart failure (CHF). This is a non-clinical (non-licensed) role focused on telephonic patient outreach, care plan support, CMS-compliant documentation, and coordination across the care team. The Care Navigator works under the supervision of RN Care Managers, escalating all clinical concerns appropriately. This role plays a critical part in reducing avoidable hospitalizations and supporting patient self-management over the long term.Key ResponsibilitiesConduct structured telephonic outreach to CHF and complex cardiac patientsMaintain an assigned patient caseload using risk stratification to prioritize outreachComplete initial assessments and follow-ups covering symptoms, medications, psychosocial status, and SDOH barriersSupport Transitional Care Management (TCM) follow-up within 48 hours post-discharge medication reconciliation, red-flag symptom screening, appointment schedulingProvide patient education on CHF self-management and evidence-based strategiesMonitor for signs of worsening conditions or care gaps and escalate to supervising RNReview and act on population health dashboards to address care gaps (wellness visits, labs, symptom monitoring)Document time, interventions, care plans, and patient goals per CMS billing standardsMaintain proactive communication with RN Care Managers, cardiologists, and PCP officesScope Limitations This Role Does NOT IncludeClinical assessment or medical diagnosisMedication prescribing or adjustmentsInterpretation of labs, imaging, or EKGsClinical triage or emergency responseIn-person or home visit patient contactBilling or coding beyond required time-based documentationExperience & SkillsRequired:Active Medical Assistant (MA) certification or equivalent clinical credential (CNA, EMT, CHW with relevant experience)Minimum 2 years of experience in care coordination, case management, or ambulatory careFamiliarity with CMS PCM, CCM, and/or TCM program requirements and documentation standardsTechnologically proficient with care coordination software and/or EHRsAI fluency actively uses AI tools to work faster and more efficiently.Must be based in and authorized to work in the United States time zone compatibility required (US business hours, CST/PST overlap)Exceptional written and verbal communication in English; strong phone presence assessed at screeningPreferred:Knowledge of cardiac conditions especially heart failure and associated comorbiditiesBilingual Spanish/English (not a must)