Medical Assistant / Care Manager – Aging in Place Program

Who We Are

At Seniors at Home, we're building something different. We believe that where you live as you age shouldn't be left to chance, and that older adults in Central Oregon deserve proactive, personalized support that keeps them healthy, independent, and genuinely thriving at home. We fill the gap in a system that has traditionally left seniors without the ongoing care coordination they need: too well for a nursing home, too complex to go it alone.

Through Medicare-covered Chronic Care Management (CCM), Principal Care Management (PCM), and Remote Physiological Monitoring (RPM), we're creating real relationships with patients, not just encounter-based visits. Our model is high-touch, team-based, and built around what matters most to each person we serve. If you want to be part of a mission-driven team that is genuinely changing how seniors experience healthcare in Bend, Redmond, La Pine, Sisters, Sunriver, and beyond - this is that opportunity.

Role Description

We're looking for a Medical Assistant / Care Manager who leads with curiosity, connects easily with older adults, and finds real meaning in being a consistent, trusted presence in someone's healthcare journey. You'll own a patient panel, serve as the primary point of contact for the people in your care, and work alongside our Nurse Practitioner to make sure nothing falls through the cracks.

Most of your work happens over the phone: weekly check-ins, coordinating care across their physicians and specialists, performing medication reconciliation, monitoring vitals remotely for potential interverntions, monitoring how patients are feeling, catching the small things that matter before they become crises. You'll also conduct in-person initial evaluations and periodic visits, bringing the human connection that phone-based care can't fully replace. The role starts part-time as you build your panel, with a clear path to full-time. We're ramping intentionally, but we're ramping fast.

What You'll Do

• Own a growing panel of Medicare patients with chronic conditions such as diabetes, COPD, hypertension, and heart failure
• Conduct structured phone check-ins covering symptoms, medications, and overall wellbeing
• Complete in-person initial evaluations and select follow-up visits
• Monitor RPM/RTM data and escalate concerns to the NP appropriately
• Document all interactions accurately in the EHR and Care Management Platform per CCM, PCM, and RPM requirements
• Assist with medication reconciliation, refill coordination, and patient self-management education
• Coordinate care across PCPs, specialists, therapists, family caregivers, and community resources
• Screen for depression, fall risk, social isolation, and medication safety concerns

What We're Looking For

• CMA, RMA, or equivalent training and experience
• Warm, patient, and comfortable building relationships with older adults over the phone and in person
• Strong documentation instincts and organized, self-directed work style
• Comfortable in a technology-enabled environment (EHR, telehealth, RPM platforms)
• Background in primary care, home health, geriatrics, or care coordination a plus
• The right mindset and character matter more than a specific background

Qualifications

• Proficiency in Medical Assisting and thorough understanding of Medical Terminology
• Experience working in a Medical Office setting, including administrative support
• Expertise in Patient Care management and engagement
• Ability to accurately handle and maintain Medical Records
• Strong organizational and time-management skills
• Adaptability to work independently in a remote setting
• Excellent interpersonal skills to build relationships with patients and families
• Experience working with senior populations is highly valued
• Certification as a Medical Assistant is preferred

Compensation: Competitive hourly rate, with hours growing alongside your patient panel.

Why Join Us:

• Flexible schedule (part-time to start, ramping to full-time)
• Mission-driven, technology-enabled model with serious growth plans
• Meaningful, ongoing patient relationships, not revolving-door encounters
• Collaborative team of NP, therapists, and care specialists
• Real autonomy and real impact

See more about our mission at www.SAHOregon.com