Care Specialist - Bilingual Spanish/English

Upward Health•Rio Rancho, NM

About The Position

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care for patients’ physical, behavioral, and social health needs. The Care Specialist is a key member of the team responsible for delivering chronic care management to high-complexity patients. The role is primarily conducted in patients’ homes and communities (90% of the time), with virtual care accounting for 10% of the time. The Care Specialist conducts direct patient outreach, guides patients through enrollment, facilitates virtual appointments with providers, and helps patients adhere to care plans. Through relationship-building, care coordination, and education, the specialist helps promote health, prevent unnecessary hospitalizations, and improve patient outcomes. The role involves working independently in an unstructured environment and collaborating with interdisciplinary teams.

Requirements

At least 2 years of relevant work experience, such as Community Health Worker, Peer Support Specialist, or Medical Assistant.
High school diploma or GED.
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 or elderly patients.
Basic computer skills, including typing and using electronic medical record systems.
Experience with motivational interviewing, trauma-informed care, and care coordination.
Strong interpersonal communication skills to engage patients and team members effectively.
Ability to prioritize tasks, manage schedules, and work independently in an unstructured environment.

Nice To Haves

Multilingual skills.
Prior home care experience.

Responsibilities

Conduct outreach to patients and guide them through the enrollment process.
Facilitate virtual appointments between patients and providers.
Help patients adhere to their care plans.
Build relationships with patients and coordinate care among patients, providers, and family members.
Educate patients about medical conditions, care plans, and available resources.
Engage patients through phone calls, home visits, and community outreach.
Manage patient caseloads, schedules, and documentation.
Document patient data accurately and in a timely manner using electronic health records and other digital tools.
Use motivational interviewing and patient-centered communication to empower patients in health decisions.
Work collaboratively with interdisciplinary teams to meet patient and organizational goals.
Support health outcomes such as care adherence, reduced emergency room visits, and improved self-management.