• Conducting outbound telephonic patient outreach to support patients enrolled in Cadence care programs • Provide one-on-one coaching and support to patients managing chronic conditions, including but not limited to type 2 diabetes, hypertension, and cardiovascular disease • Help patients execute personalized care plans and achieve their goals by providing education and coaching focused on behavior modification, nutrition, physical activity, and self-management strategies using evidence-based techniques such as motivational interviewing and SMART goals • Conduct comprehensive assessments of patients' health status, lifestyle behaviors, nutritional habits, and readiness to change • Support patient care delivery by performing assigned tasks in accordance with Cadence clinical policies and established protocols, under appropriate clinical supervision • Educate patients on disease management, medication adherence, symptom recognition, and prevention strategies • Monitor patients' progress, adherence to treatment plans, and health outcomes through regular check-ins and remote monitoring tools • Documenting patient interactions, outcomes, and follow-up plans in the Cadence platform • Identifying barriers to care (including social needs) and connecting patients with resources or internal support pathways • Collaborating in real time with clinicians and patient support teams using tools such as our Cadence Platform, Google Workspace, and Slack • Contributing feedback to improve workflows in a fast-moving, change-oriented environment