Job Description:

• Conduct outbound telephonic patient outreach and provide one-on-one coaching and support to patients managing chronic conditions, including but not limited to type 2 diabetes, hypertension, and cardiovascular disease.
• Help patients execute personalized care plans and achieve their goals by providing education and coaching focused on behavior modification, nutrition, physical activity, and self-management strategies using evidence-based techniques such as motivational interviewing and SMART goals.
• Conduct comprehensive assessments of patients' health status, lifestyle behaviors, nutritional habits, and readiness to change.
• Educate patients on disease management, medication adherence, symptom recognition, and prevention strategies, and execute care delivery tasks in accordance with Cadence clinical policies and established protocols, under appropriate clinical supervision.
• Monitor patients' progress, adherence to treatment plans, and health outcomes through regular check-ins and remote monitoring tools.
• Document patient interactions, outcomes, and follow-up plans in the Cadence platform; identify barriers to care (including social needs) and connect patients with resources or internal support pathways.
• Collaborate in real time with clinicians and patient support teams using tools such as our Cadence Platform, Google Workspace, and Slack, and contribute feedback to improve workflows in a fast-moving, change-oriented environment.

Requirements:

• An active Medical Assistant certification from an accredited association (either AAMA, AMCA, AMT, NHA, NAHP or NCCT) is required.
• At least 5 years of experience as a Medical Assistant is required.
• Remote work readiness (including stable high-speed WiFi) is required.
• Experience working in internal medicine, cardiology, nephrology or with the geriatric population is preferred.
• Experience providing patient education and support to individuals managing chronic conditions is preferred.
• Fluency in Spanish is required.
• Fluency with AI-assisted clinical tools (such as Gemini, Open Evidence, or comparable platforms) and the ability to speak credibly with providers and patients about where AI supports care delivery and where human judgment remains non-negotiable.

Benefits:

• Competitive pay & equity*

• Fully remote

• Comprehensive health coverage: Medical, dental & vision
• Paid time off
• 401k plan + matching
• Paid parental leave
• Home office stipend