Patricia began his coaching career as a graduate assistant at his alma mater, RPI, in 1996. He spent the next two seasons out of football before returning as the defensive line coach for Amherst College from 1999 to 2000. In 2001, he moved to Syracuse University as an offensive graduate assistant for the team, a position he held for three seasons. Patricia is a brother of Theta Chi Fraternity.
Patricia joined the Patriots as an offensive coaching assistant in 2004. In 2005, upon the departure of assistant offensive line/tight ends coach Jeff Davidson, Patricia was re-assigned as the Patriots' assistant offensive line coach. Then-linebackers coach Dean Pees was promoted to defensive coordinator after the season, prompting another re-assignment for Patricia, this time to linebackers coach for the 2006 season. Patricia was named the team's safeties coach in 2011. In 2012, he received the title of defensive coordinator, despite having called plays on defense since the departure of Pees following the 2009 season. He won Super Bowl XLIX with the Patriots at the end of the 2014 season, as well as Super Bowl XXXIX at the end of the 2004 season. In January 2016, the Patriots gave permission for Patricia to interview for the head-coaching position of the Cleveland Browns.