Integrated Care Coach

CenterWell Senior Primary Care is a dedicated healthcare organization specializing in providing proactive and preventive care specifically designed for seniors. As part of Humana Inc., a leading health and well-being company, CenterWell Senior Primary Care is committed to delivering compassionate, comprehensive, and personalized care to the aging population. The organization’s care model emphasizes taking time to listen and understand the unique needs of each patient, addressing not only their physical health needs but also social and emotional wellness. This holistic approach is supported by integrated care teams comprising physicians, nurses, behavioral health specialists, and other healthcare professionals. Collectively, these teams spend up to 50 percent more time with patients, ensuring personalized attention that contributes to improved health outcomes. CenterWell is recognized as the largest provider of senior-focused primary care and continues to expand its influence in home healthcare and integrated pharmacy services. Its mission extends to fostering accessible, high-quality healthcare experiences that respect the dignity and individuality of every senior patient.

The Care Coach role within the CenterWell and Conviva Primary Care organization is pivotal in advancing this mission by providing targeted care coordination and social support to the highest-risk patients—constituting the top 5 percent of the patient population. This role is fundamentally focused on proactive, patient-centered care that navigates the complexities faced by seniors with chronic conditions or medical complexities. Reporting to a Care Integration Team Manager, the Care Coach acts as the primary point of contact for patients, ensuring they receive comprehensive support across clinical, social, and environmental domains.

The Care Coach’s responsibilities are broad and involve clinical screening, patient advocacy, chronic disease education, and community engagement. In addition to conducting structured patient interviews and home visits to assess living conditions and barriers, the Care Coach coordinates with primary care providers, specialists, pharmacies, and community resources to facilitate seamless care transitions and close care gaps. The role demands cultural competence, especially given the bilingual requirement in English and Spanish, enabling effective communication and culturally sensitive care delivery.

The job requires a mobile presence, involving travel to patients' homes, healthcare facilities, and community-based settings. The expected work style includes a balance of clinic-based and field work, typically with two days per week physically in the center and two days visiting patients’ homes. Working hours are Monday through Friday, 8:00 AM to 5:00 PM, with the possibility of overtime. The compensation for this full-time role ranges between $53,700 and $72,600 annually, with eligibility for bonus incentives based on performance.

Humana, through CenterWell, supports its employees with a comprehensive benefits package from day one, including health benefits, paid time off, retirement savings with employer matching, tuition assistance, parental leave, and career development opportunities. This inclusive and supportive environment promotes both professional growth and personal wellness. The Care Coach position offers a meaningful opportunity to impact the lives of seniors by improving health outcomes, enhancing quality of life, and ensuring patient voices are heard and valued within the healthcare system.