Certified Medical Assistant - Chronic Care Management

We are seeking a detail-oriented and patient-focused Certified Medical Assistant to support our Chronic Care Management program. This role is responsible for enrolling eligible patients, coordinating ongoing care for an assigned panel, and ensuring continuity of care for individuals with chronic conditions. The position blends patient outreach, care coordination, and in-clinic support to enhance patient outcomes and engagement.

Key Responsibilities:

• Identify and enroll eligible patients into the CCM program, including educating patients on program benefits and obtaining informed consent.
• Manage an assigned panel of CCM patients
• Coordinate patient care in collaboration with providers, including appointment scheduling, specialist referrals, medication refill requests, and follow-up on labs and diagnostic testing.
• Support transitions of care by coordinating post-discharge follow-up, home care services, and community resources to reduce avoidable hospital readmissions.
• Serve as a patient advocate by addressing barriers to care, facilitating access to community and support services, and promoting disease prevention and self-management.
• Accurately document all patient interactions, care coordination activities, and administrative functions in the electronic medical record to ensure compliance with CCM program and billing requirements.

Schedule & Compensation:

• Hourly Rate: $23–$25 per hour
• Location: Amherst and Northampton, MA (rotation between sites required)
• Schedule: Monday–Friday, 40 hours per week

Qualifications:

• Certified Medical Assistant required
• Minimum of 1 year of experience in a medical office or primary care setting