Care Specialist - Bilingual Spanish/English

Upward Health•Las Cruces, NM

About The Position

The Care Specialist is a key member of the team responsible for delivering chronic care management to high-complexity patients. The role is primarily based in patients’ homes and communities (90% of the time), with virtual care accounting for 10% of the work. The Care Specialist conducts direct outreach, guides patients through enrollment, facilitates virtual appointments with providers, and supports adherence to care plans. Through relationship-building, care coordination, and education, the Care Specialist helps promote health, prevent unnecessary hospitalizations, and improve patient outcomes. The role requires working independently in an unstructured environment while collaborating with interdisciplinary teams. Care Specialists use patient-centered communication and motivational interviewing to engage patients, coordinate with providers and family members, educate patients about conditions and resources, and maintain accurate, timely documentation. The position involves travel within an assigned territory for home and community visits, as well as phone-based and virtual patient engagement.

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 EMR 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.
Excellent verbal and written communication skills, including the ability to explain complex medical information clearly and supportively.
Strong organizational, critical-thinking, and problem-solving skills.

Nice To Haves

Multilingual skills are a plus but are not required.
Prior home care experience is beneficial.

Responsibilities

Conduct direct outreach to patients and guide them through the enrollment process.
Facilitate virtual appointments with providers.
Support patients in adhering to their care plans.
Build relationships with patients and coordinate care with providers, family members, and interdisciplinary teams.
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 information accurately and in a timely manner using EMR systems and other digital tools.
Use motivational interviewing and patient-centered communication to support patients in taking ownership of their health decisions.
Assess patient needs and develop appropriate care strategies.
Work toward improved care adherence, fewer emergency room visits, and enhanced patient self-management.
Travel within the assigned territory to meet patients in their homes and communities.