Care Concierge

What You’ll Do

Your assignment across enrollment, welcome visits, and care navigation on any given day will be determined by the team lead based on real-time queue volume and staffing needs.

Enrollment — Introducing the Program & Securing Participation

• Conduct outbound outreach to prospective program participants, working a structured referral queue with consistency and professionalism.
• Introduce the program using plain, accessible language — communicating tangible benefits without clinical jargon or unnecessary complexity.
• Build rapport with older adults, including those who may be skeptical, confused, or reluctant.
• Proactively address common concerns and objections with warmth and confidence.
• Obtain all required verbal consents individually and in sequence — consent documentation is a hard compliance gate; no scheduling proceeds without it.
• Complete and document an intake questionnaire with prospective members who wish to enroll.
• Coordinate and schedule the member’s initiating provider appointment upon successful enrollment.

Member-Facing Visits

• Conduct the welcome visit with newly enrolled members — the first in-depth touchpoint after enrollment — setting expectations for how the program will support them.
• Explain how ongoing coordination will work going forward.
• Provide condition-specific education tailored to the member’s literacy level, language, and learning preferences.
• Coach members on self-management basics: symptom monitoring, when to call the doctor, medication routines.
• Use motivational interviewing techniques and deliver culturally sensitive, trauma-informed care.
• Complete or confirm initial SDOH screening and flag any immediate barriers to the pod for follow-up.
• Set the member up for a seamless transition into ongoing coordination, documenting thoroughly so anyone in the pod can assist without a gap.

Care Navigation & Coordination — Closing Gaps, Connecting Resources

• Serve as a liaison between members, primary care providers, specialists, pharmacies, home health agencies, and community resources.
• Proactively coordinate with PCP offices to push through referrals, prior authorizations, and medication changes — following up persistently until the task is completed, not just submitted.
• Support medication adherence by identifying barriers, educating on proper use, and escalating discrepancies or concerns to care navigation staff.
• Help members access affordable medication through insurance benefit exploration, RX discount programs, manufacturer coupons, and member assistance programs.
• Help members access durable medical equipment, transportation services, meal programs, and other community-based resources.
• Conduct structured SDOH screenings using validated tools to identify barriers such as food insecurity, housing instability, transportation challenges, and financial strain.
• Own the full chain from identification through resolution — confirming the member actually received the service, not just that a referral was made.
• Build and maintain a regional resource directory, updating it as programs and eligibility requirements change.
• Escalate care navigation concerns to the team lead promptly and clearly.

Across All Areas

• Document every member interaction accurately in real time.
• Follow consent and compliance procedures without exception — gates apply regardless of volume or time pressure.
• Work fluidly across multiple platforms — care navigation system, CRM, Google Workspace, G-Chat — adapting quickly as tools and workflows evolve.
• Respond constructively to quality audits, coaching, and feedback, and flag workflow or platform issues as you encounter them.

KPIs You’ll Drive

Enrollment

• Outreach attempts per day, contact rate, and average attempts to contact

Member-Facing Welcome Visits

• Welcome visit completion rate and timeliness relative to enrollment date
• Member-reported experience following the welcome visit

Care Navigation & Coordination

• Care gap closure — identified gaps resolved or actively in progress each month
• Resource connection rate — members with identified SDOH needs successfully connected to resources or benefit programs
• Escalation response time — concerns escalated to supervising LVN same day they are identified
• Appointment adherence support — follow-up appointments confirmed and transportation arranged post-transition

Shared Across the Pod

• Documentation accuracy & timeliness — % of interactions with complete, same-day documentation across all three functions
• Call/interaction quality score — from structured coaching and QA reviews, spanning compliance gate adherence, rapport, plain language use, and objection handling
• Productivity — pod workload managed with consistent daily and weekly output across enrollment, coordination, and welcome visits, both volume and quality