Chronic Care Manager

Job Type: Full-Time
Position Location: Prescott

Make a Difference in Patients' Lives

Are you passionate about helping patients manage chronic health conditions and achieve better health outcomes? We are looking for a compassionate, organized, and patient-focused Chronic Care Manager to join our Medical Services team.

In this role, you will help patients navigate their healthcare journeys through personalized care planning, ongoing follow-up, patient education, and care coordination. You will work closely with patients, caregivers, healthcare providers, and community partners to address barriers to care, encourage healthy habits, and support continuity of care.

If you enjoy building meaningful patient relationships, coordinating services, and helping people take an active role in their health, we encourage you to apply.

What You'll Do

Care Planning and Coordination

Collaborate with patients, caregivers, and healthcare providers to develop and update individualized care plans.
Identify patient goals, gaps in care, and barriers to following recommended treatment plans.
Coordinate communication among physicians, specialists, nurses, and other healthcare professionals.
Help patients navigate healthcare services and maintain continuity of care.

Patient Follow-Up and Support

Conduct scheduled patient check-ins to monitor progress, assess needs, and encourage engagement in care plans.
Follow up on patient-reported medication adherence, appointments, treatment recommendations, and health goals.
Identify concerns and communicate them to the appropriate licensed healthcare provider.
Encourage patients to take an active role in managing their chronic conditions.

Patient Education

Provide approved education on chronic conditions, preventive care, lifestyle modifications, and care-plan goals.
Support patients and families in understanding treatment recommendations and available healthcare resources.
Help patients overcome barriers that may affect their ability to follow their care plans.

Documentation and Community Resources

Maintain accurate and timely documentation of patient interactions, interventions, care coordination, and follow-up activities in the electronic health record (EHR).
Connect patients with community organizations and social services to address needs such as transportation, food access, and housing.
Protect patient confidentiality and follow organizational policies and applicable healthcare regulations.
Perform other duties as assigned.

What We're Looking For

Required Qualifications

High school diploma or GED equivalent.
At least one year of clinical or medical assistant work experience.
At least one year of experience using electronic medical records (EMR) or electronic health records (EHR).

Preferred Qualifications

Experience in chronic care management, care coordination, or population health.
Bilingual proficiency in English and Spanish.

Skills for Success

The ideal candidate will have:

Strong written and verbal communication skills and a professional, patient-centered approach.
Excellent customer service, interpersonal, and relationship-building skills.
The ability to manage multiple priorities, meet follow-up deadlines, and work independently.
Effective communication skills when working with patients, caregivers, and healthcare professionals.
A working understanding of chronic disease management, preventive care, and patient education.
Proficiency in EHR/EMR systems and healthcare technology tools.
The ability to recognize barriers to care and connect patients with appropriate community resources.
Sound judgment, attention to detail, and a strong commitment to patient privacy and confidentiality.

Why Join Our Team?

As a Chronic Care Manager, you will play an important role in helping patients feel supported, stay connected to their healthcare team, and work toward their health goals. Your work will help improve care coordination, strengthen patient engagement, and make healthcare easier to navigate for the people who need it most.

Ready to Make an Impact?

If you are organized, compassionate, and committed to helping patients manage their health, we would love to hear from you. Apply today to join our Medical Services team as a Chronic Care Manager.