Job Description
Why Vitasora Health
Vitasora Health is redefining how chronic care is delivered in America. We connect patients, providers, and payers through a technology-driven platform built around RPM, CCM, and telehealth, making proactive, continuous care accessible beyond the clinic. Joining Vitasora means being part of a mission-driven team that is not just responding to the future of healthcare; we are building it.
What Vitasora Health Offers
We offer a competitive compensation package including comprehensive medical, vision, and dental coverage, a 401(k) plan, and paid time off. You’ll join a collaborative, high-energy environment where innovation is encouraged, contributions are recognized, and careers grow alongside a company shaping the future of remote care.
Job Description
The Care Coordinator is a clinical cornerstone of Vitasora Health’s remote care team, responsible for managing the ongoing health needs of patients enrolled in Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) programs. This role combines clinical expertise with advanced patient engagement skills including motivational interviewing and health coaching to build meaningful, trusting relationships that support lasting behavior change and improved outcomes for patients managing chronic conditions such as cardiovascular disease, diabetes, obesity, and respiratory challenges. Rooted in Vitasora’s values of respect, accountability, innovation, and unity, the Care Coordinator delivers care that goes beyond the clinic.
Core Responsibilities
Patient Engagement & Health Coaching
Lead monthly patient outreach calls using motivational interviewing to drive behavior change and support self-directed health goals
Guide patients through personalized goal-setting, care planning, and accountability using evidence-based coaching techniques
Deliver culturally responsive health education and self-management strategies for chronic conditions in plain, accessible language
Address social determinants of health and remove barriers to care, with a focus on underserved and rural populations
Care Coordination & Collaboration
Act as the central connection between patients and their care teams, facilitating seamless communication across physicians, nurses, social workers, and specialists
Monitor patient progress via RPM data and regular touchpoints; escalate clinical concerns using structured protocols
Participate in team huddles and case reviews to align on priorities and optimize patient outcomes
Clinical Documentation & Compliance
Maintain accurate, HIPAA-compliant documentation of all patient interactions and care plans within the EHR
Ensure compliance with CMS Chronic Care Management guidelines, NCQA standards, and Joint Commission requirements
Track engagement metrics and contribute insights to program performance reporting
Patient Advocacy
Proactively connect patients with community resources and support networks to overcome barriers to care
Champion the patient's voice within the care team, ensuring their goals and preferences drive clinical decision-making
This role may require completion of tasks and responsibilities outside of those listed above, as business needs evolve. Flexibility and a willingness to contribute beyond defined expectations is an important part of this role.
Required Qualifications
Must hold an active and unrestricted Licensed Practical Nurse (LPN) or Registered Nurse (RN) license issued by the State of California.
Minimum 2 years of clinical experience in chronic care management, telehealth, primary care, or a related setting; 5+ years preferred.
Demonstrated knowledge of and experience applying motivational interviewing (MI) and/or health coaching techniques in a clinical or patient engagement setting.
Proficiency in EHR systems, telehealth platforms, and remote patient monitoring tools.
Strong verbal and written communication skills with the ability to engage patients empathetically, navigate objections, and promote behavior change.
Familiarity with CMS CCM guidelines, HIPAA regulations, NCQA standards, and EOC requirements.
Preferred Qualifications
Experience with motivational interviewing and/or health coaching to improve patient outcomes.
Experience working with Medicare and Medicaid patients and managing complex chronic disease populations.
Knowledge of social determinants of health and their impact on rural and underserved communities.
Proven ability to build rapport quickly and professionally handle objections.
Prior experience in telehealth, RPM, or other virtual care delivery models.
Understanding of HIPAA and commitment to patient confidentiality.
Bilingual proficiency in English and Spanish.
Core Competencies
Motivational Interviewing & Behavior Change Support
Health Coaching & Patient Goal-Setting
Patient-Centered Communication & Active Listening
Chronic Care Management & Clinical Documentation
Healthcare Compliance & HIPAA Awareness
Interdisciplinary Collaboration & Care Coordination
EHR, Telehealth & Remote Monitoring Technology
Cultural Qualifications
Intellectually curious and mission-driven motivated by making a lasting, meaningful difference in patients’ lives.
Approaches every patient interaction with genuine empathy, cultural humility, and a human-first mindset.
Thrives in a nimble, fast-paced environment; adaptable and ready to evolve with the needs of a growing health tech company.
Embodies the Vitasora spirit: mission-focused, humble in leadership, relentless in execution, and emotionally intelligent in team dynamics.
Embraces challenges with a “can do” mentality and is committed to going the extra mile for patients and teammates alike.
Values authenticity and brings a collaborative, positive energy to every interaction—with patients, peers, and partners.
Schedule & Availability
This role requires flexibility in scheduling based on business needs, which will be communicated well in advance. Team members may be asked to adjust working hours, including early mornings, evenings, or occasional weekends, to support patient outreach goals, program deadlines, or operational demands. A willingness to work flexible hours is an important part of this role.
Physical & Remote Work Requirements
Prolonged periods of sitting and working on a computer.
Reliable high-speed internet (minimum 50 Mbps) and quiet, distraction-free workspace.
Must be able to lift up to 15 pounds at times.
Vitasora Health is an Equal Opportunity Employer (EOE) and does not discriminate based on race, color, religion, gender, sexual orientation, national origin, disability, or veteran status. We are committed to fostering an inclusive and diverse workplace that reflects the communities we serve.