Clinical Care Coordinator Job at Phamily, New York, NY

QUx3RlY2Vmh1Ulo2MjRCTUN0Z2xqOUF0NGc9PQ==
  • Phamily
  • New York, NY

Job Description

Job Description

Job Description

Job Title: Clinical Care Coordinator (Remote) – Text-Based APCM Program

Department: Clinical Operations
Location: Remote (Flexible remote schedule across CST, EST, or PST time zones )

Position Type: Full-Time

OVERVIEW

Our team is growing! Jaan Health is seeking dynamic and motivated Licensed Practical Nurses (LPNs) Clinical Care Coordinators to join our care team and will report to the Clinical Operations Manager. This role requires strong clinical knowledge, adaptability, and the ability to thrive in a fast-paced, patient-centered environment. The LPN will support chronic care management (CCM) and advanced primary care models (APCM) by providing direct patient engagement, care plan support, and clinical triage. This position is remote and offers health benefits as well as a retirement plan and paid days off.

Our company serves 90+ clients who care for over 50,000 patients. We are a rapid-growth B2b SaaS company that offers our clients a software platform called Phamily ( to provide connected care management to their patients. Phamily keeps patients in contact with their care manager, who regularly checks up on them and acts as a resource for any concerns they might have about their health in order to keep them happier and healthier for longer.

About the Role

We are seeking a compassionate, organized, and tech-savvy Clinical Care Coordinator to support patients with chronic conditions in our text-based Advanced Primary Care Management (APCM) program. This remote role focuses on delivering proactive, high-quality care through digital communication tools, driving better health outcomes for Medicare and older adult populations.

This position is ideal for healthcare professionals who thrive in a virtual care setting, value patient engagement, and are skilled in critical thinking and care coordination.

Candidates in other locations may apply, but applications will be held until there are additional resources needed outside of the initial target areas.

Key Responsibilities
  • Serve as the first line of communication for patients via a secure, text-based platform
  • Monitor and respond to patient messages and check-ins in a timely, compassionate, and professional manner

  • Identify, assess, and triage clinical concerns, SDOH needs, and care coordination barriers
  • Develop and update personalized care plans for patients with chronic conditions (e.g., hypertension, diabetes, COPD)
  • Develop, implement, and revise care coordination workflows or protocols to support the evolution of the care model to improve efficiency and scalability
  • Analyze patient data or trends to identify care gaps or improve outcomes
  • Independently making decisions on patient outreach priorities, resource allocation, or escalation paths
  • Lead quality improvement initiatives or case review meetings
  • Serve as a liaison for payer utilization management, interpreting policy, and advising on compliance
  • Track engagement, log care time, and document all communication per HIPAA and program guidelines
  • Identify and troubleshoot issues that arise during new program iterations, escalating to leadership when there are critical impacts or opportunities for system-wide improvements
  • Collaborate with RNs, NPs, and Social Workers to ensure timely escalation and follow-through

Key Skills & Qualifications
  • 2+ years of experience in a clinical or care coordination role (primary care, chronic care management, home health, etc.)
  • LPN w/ compact license strongly preferred
  • Strong critical thinking and problem-solving skills in a fast-paced environment
  • Ability to independently manage a digital patient panel and prioritize escalations effectively
  • Excellent written communication and documentation skills
  • Comfort using EMRs, care coordination platforms, and digital messaging tools
  • Knowledge of Medicare CCM/APCM programs a plus
  • Bilingual (Spanish) is a bonus but not required
  • Must be located within the continental United States and have access to reliable internet and ability to work in a specified time zone - either CST, EST, or PST depending on client and candidate location
  • Access to Internet 5G
Schedule & Work Environment
  • Full-time, Monday–Friday
  • Flexible remote schedule across CST, EST, or PST time zones
  • 1-hour lunch break, daily huddles with manager/team
  • Ongoing support from a multidisciplinary care team
Why Join Us?
  • Mission-driven organization focused on health equity and innovative digital care
  • Collaborative, diverse, and growth-focused culture
  • Opportunities for professional development and internal promotion
  • Competitive compensation and benefits package
  • Be part of redefining how care is delivered—one text at a time

Job Tags

Full time, Monday to Friday, Flexible hours,

Similar Jobs

Mesch Cleaning Services LLC

Office Assistant Receptionist Job at Mesch Cleaning Services LLC

Job Description Job Description Answering phone, booking clients, working on computer, working with vendors Company Description De-Stress the mess with Mesch Company Description De-Stress the mess with Mesch

IDC Management LLC

Staff Accountant Job at IDC Management LLC

 ...Job Description Staff Accountant OAK RIDGE, TN $50,000 $62,000 Annually Job Title: Staff Accountant Location: Oak...  ...in Sage Intacct is desired. Minimum of 3 years accounting experience. Strong understanding of accounting principles and practices... 

Mercy

RN - Registered Nurse- Float Pool, Mercy South - 12 & 8 hour shifts Job at Mercy

 ...MO 63128 Registered Nurse Full Time or Part Time Opportunities Available Are you...  ...shifts: 7 AM 7 PM or 7 PM 7 AM ~8-hour evening shifts: 3 PM 11 PM Competitive...  ...: +$2.75/hr Night: +$4.60/hr Weekend: +$1.50/hr Sign-On Bonus: Up to$1... 

The Goddard School

Chinese Teacher: Part Time Job at The Goddard School

The Goddard School of Bethesda is looking for an energetic, warm, and engaging Part Time Chinese Language teacher.A Chinese Teacher at The Goddard School is responsible for establishing and maintaining a safe, healthy and nurturing learning environment. Additionally... 

Boeing

Senior / Lead Aeroelasticity and Dynamics Engineer Job at Boeing

 ...Find your future with us. The Boeing Defense, Space & Security (BDS) organization is seeking a Senior/Lead Aeroelasticity and Dynamics Engineer to support tactical aircraft programs in Hazelwood, MO ! As a member of the BDS Fixed-Wing Loads & Dynamics (L&D) Capability...