Remote Care Coordinator - Cardiac

Cardiac Care Alliance (CCA)Cardiac Care Alliance is a Management Services Organization (MSO) committed to building a high-performance cardiovascular network. We partner with independent cardiologists to deliver value-based care (VBC) models that complement traditional fee-for-service delivery. Our mission is to improve patient access, clinical outcomes, and overall experience through proactive care coordination and evidence-based interventions.Position SummaryCCA is hiring full-time virtual Care Coordinators to support a growing population of medically complex patients with cardiac conditions, primarily congestive heart failure (CHF). This role is integral to our population health initiatives — proactively supporting at-risk patients with data-informed outreach, continuity of care, and patient-centered engagement.This role will focus on supporting Principal Care Management (PCM), Chronic Care Management (CCM), and Transitional Care Management (TCM) services via telephonic outreach and technology-enabled documentation platforms. Care Coordinators work collaboratively with a team of Registered Nurses and Cardiologists, escalating clinical concerns and complex care needs as appropriate.This position does not require RN licensure, but candidates must have strong clinical acumen, attention to detail, and the ability to navigate complex care environments.Key ResponsibilitiesConduct structured telephonic outreach to CHF patients and other complex cardiac patientsMaintain a caseload of assigned patients, using risk stratification to prioritize careComplete initial assessments and timely follow-ups addressing current symptoms, medication regimen and adherence, functional and psychosocial statusAssess home safety and social determinants of health (SDOH) barriers, including transportation, food insecurity, housing instability, and caregiver support; escalate resource needs where appropriateAdvance care planning needs and specialty care follow-upReview and act on population health dashboards to address care gaps (annual wellness visits, missing labs, lack of symptom monitoring, etc.)Provide ongoing patient education and promote evidence-based self-management strategies for CHFMonitor for signs of worsening conditions or gaps in care, and escalate as neededSupport transitional care follow-up within 48 hours post-discharge, focusing on medication reconciliation, red-flag symptom screening, and appointment schedulingDocument time, interventions, care plans, and patient goals in the care management platform in alignment with CMS billing standardsMaintain proactive communication with RNs, Cardiologists, PCP offices, and other clinical partnersScope of Work – LimitationsThis role is non-clinical in license and does not include:Clinical assessment or medical diagnosisMedication prescribing or adjustmentsInterpretation of diagnostic results (labs, imaging, EKGs, etc.)Clinical triage or emergency responseHome visits or in-person patient contactBilling or coding responsibilities beyond required documentationAll clinical decision-making, care plan authorization, and treatment recommendations are made by licensed providers and/or supervising RNs.QualificationsRequired:Active Medical Assistant (MA) certification or equivalent clinical credential (e.g., CNA, EMT, CHW with experience)Minimum 2 years of experience in care coordination, case management, or ambulatory careStrong interpersonal communication skills and ability to build rapport by phoneFamiliarity with CMS PCM, CCM, and/or TCM program requirementsTechnologically proficient with care coordination software or EHRsAbility to work independently and efficiently in a remote environmentPreferred:Knowledge of chronic conditions, especially heart failure and associated comorbiditiesBased in or familiar with the Dallas/Fort Worth regionBilingual (Spanish/English)Position DetailsEmployment Type: Full-Time, W-2 ContractSchedule: 40 hours per week, Monday–Friday (flexible business hours)Compensation: $26–$32/hour (based on experience and qualifications)Work Environment: 100% Remote (Dallas/Fort Worth area preferred)Potential for ongoing engagement or full-time employment for the right candidateMust have a dedicated, private workspace suitable for handling PHI, a secure internet connection, and comply with HIPAA and patient privacy policies at all times