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Clinical Program Manager, Care Navigation, US Remote

2 weeks, 6 days ago
United States
Full-time
Senior
Operations Manager
Project and Program Management
Chi HIPAA
Apply Now
Carewell

Carewell

Carewell provides a comprehensive range of home health products designed for caregivers, offering discreet packaging, 24/7 support, and educational resources to enhance the caregiving experience.

Health Care Providers & Services
51-250
Founded 2017
$5M raised
View All Jobs 5

Description

  • Design and implement care navigation workflows, SOPs, clinical standards, and program parameters from the ground up.
  • Lead hiring for advocates, CHWs, LVNs, and other clinical staff in coordination with leadership and HR.
  • Manage, mentor, and evaluate the performance of a multidisciplinary clinical team.
  • Conduct performance reviews, coaching, and corrective action when needed.
  • Define and implement quality improvement processes to continuously improve program performance.
  • Evaluate, select, and implement care management technology, EHR platforms, and digital tools.
  • Manage vendor relationships and oversee system integration and optimization.
  • Develop and execute within a clinical program budget.
  • Establish documentation standards, clinical behavioral standards, and performance expectations.
  • Ensure compliance with Medicare billing requirements, HIPAA, state telehealth laws, and other applicable regulations.
  • Develop clinical risk management protocols and escalation pathways.
  • Create reporting frameworks and deliver clinical outcomes, quality, and compliance reporting to stakeholders, providers, and payers.
  • Deliver hands-on care navigation services to a limited caseload during the initial launch phase.
  • Conduct SDOH screenings and connect patients to community resources.
  • Build trusted relationships with patients, families, and care teams.

Requirements

  • Active Nurse Licensure Compact (NLC) multistate license, with willingness to obtain licensure in non-NLC states as the program expands.
  • LVN preferred; RN considered for candidates with demonstrated leadership experience and program-building aptitude.
  • Direct experience with minute-by-minute, time-based documentation for Medicare billing in programs such as CCM, TCM, PCM, CHI, RPM, or similar.
  • 3–5+ years of experience in care navigation, case management, care coordination, or closely related patient-facing roles.
  • Demonstrated ability to deliver remote care management and coordinate care using telephonic and digital tools.
  • Proven experience leading, mentoring, or supervising clinical or operational teams.
  • Comfort navigating social determinants of health and connecting patients to resources across complex systems.
  • Working understanding of Medicare regulations, HIPAA, and state telehealth compliance requirements.
  • Track record implementing quality improvement processes to improve clinical outcomes and operational performance.
  • Experience evaluating, selecting, and implementing care management platforms, EHRs, or related clinical systems.
  • Startup, pilot program, or ground-up initiative experience preferred.
  • Familiarity with value-based care or population health models preferred.
  • Bilingual ability in Spanish or another language relevant to the target population preferred.
  • CHW certification preferred.
  • Experience with Motivational Interviewing or trauma-informed care frameworks preferred.
  • Background in vendor management or platform procurement preferred.

Benefits

  • Competitive compensation with growth trajectory tied to program expansion.
  • Health, dental, and vision insurance.
  • Short-term disability and life insurance, 100% employer-sponsored.
  • Long-term disability coverage.
  • Supplemental life insurance, employee-sponsored.
  • 401(k) retirement plan.
  • 100% remote work.
  • Generous paid time off plus 6 paid holidays.

Interested in this position?

Apply directly on the company website

Apply Now

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