# Clinical Program Manager, Care Navigation, US Remote **Company:** [Carewell](http://jobs.workable.com/companies/3thL9S7L1w3xnozZJSijLp.md) **Location:** Remote **Workplace:** remote **Employment type:** Full-time [Apply for this job](http://jobs.workable.com/view/e204f8ef-7fc1-4c1e-845c-a404bfb8f33d) ## Description ### About Carewell Carewell is a category-defining business dedicated to providing trusted caregiving solutions and support for individuals and families. Through Carewell Family Services, we extend our commitment beyond products to person-centered navigation, care coordination, and advocacy services that address both medical and social needs. Our approach emphasizes compliance, scalability, and high-quality patient experiences while working in close partnership with clinicians and community resources to support better outcomes. ### About the Role This is a rare opportunity to be the first clinical hire and program leader for a growing care navigation program. You'll design, build, and operationalize the infrastructure, workflows, and clinical standards that define how we deliver care at scale — while carrying a limited direct patient caseload during the initial launch phase to inform program design. As you build the program, you'll simultaneously build and lead a multidisciplinary team of advocates, CHWs, LVNs, and other clinical staff. If you're energized by building systems, leading teams, and driving measurable outcomes in a high-growth environment, this role was written for you. ### What You'll Do **Program Leadership & Operations** - Design and implement care navigation workflows, SOPs, clinical standards, and program parameters from the ground up - Lead the hiring for advocates, CHWs, LVNs, and clinical staff by defining role requirements, conducting interviews, and making hiring decisions in coordination with leadership and HR. - Lead, mentor, and manage performance of a multidisciplinary clinical team - Conduct performance reviews, coaching, and corrective action as needed - Define and implement quality improvement processes to drive continuous program enhancement - 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 - Serve as a culture carrier and clinical role model as the team scales **Clinical Oversight & Quality** - Establish and monitor documentation standards, clinical behavioral standards, and performance expectations - Ensure regulatory compliance with Medicare billing requirements, HIPAA, state telehealth laws, and other applicable regulations - Develop clinical risk management protocols and escalation pathways - Oversee appropriate documentation across all systems to support compliance and billing accuracy - Ensure time-based documentation standards are met (start time, stop time, duration tracking for monthly minute aggregation) **Measurement, Reporting & Accountability** - Develop reporting frameworks for clinical outcomes, quality metrics, and compliance indicators - Deliver clinical outcomes reporting to internal stakeholders, providers, and payers - Track and report on program KPIs (see below) - Use data insights to inform strategic decisions and drive program iteration **Direct Patient Care (Initial Launch Phase)** - Deliver hands-on care navigation services to a limited caseload during program launch to inform workflow design - Conduct SDOH screenings and connect patients to community resources - Build trusted relationships with patients, families, and care teams - Model best practices for documentation and clinical excellence ### KPIs You're Responsible For **Clinical Performance** - Clinical team productivity (encounters per clinician, time utilization) - Clinical outcomes (disease management metrics, care plan adherence, hospitalization/readmission rates) - Care gap closure rate - Escalation pattern analysis (volume trends, root cause, training signal identification) - Patient NPS and satisfaction scores - Patient Engagement **Program Quality & Compliance** - Documentation compliance rates - Clinical behavioral and performance standards adherence - Clinical protocol adoption, consistency across pods, and iteration cadence - Safety event tracking and response times - Regulatory audit readiness **Operational Efficiency** - Average time-to-resolution for patient needs - Caseload capacity and coverage relative to patient volume - Resource utilization rates - Cost per patient served - Revenue cycle metrics (as applicable) **Team & Growth** - Supervisor performance and development - Team scaling velocity and time-to-productivity for new hires - Staff retention and engagement **Reporting & Outcomes** - Timely delivery of internal, provider, and payer-facing clinical reports - Quality of reporting frameworks and data integrity ### Who You Are **Must-Have Requirements** - Licensed for multi-state practice — Active Nurse Licensure Compact (NLC) multistate license; prepared to obtain licensure in non-NLC states as program expands - Clinical credentials — LVN preferred; RN considered for candidates with demonstrated leadership experience and genuine appetite for building and managing programs - Medicare billing expertise — Direct experience working in a program that required minute-by-minute, time-based documentation for Medicare billing (CCM, TCM, PCM, CHI, RPM, or similar programs) - Care navigation or case management experience — 3–5+ years in care navigation, case management, care coordination, or closely related patient-facing roles - Telehealth expertise — Demonstrated ability to deliver remote care management, build rapport, and coordinate care via telephonic and digital tools - Management experience — Proven track record leading, mentoring, or supervising clinical or operational teams - SDOH fluency — Comfortable navigating social determinants and connecting patients to resources across complex systems - Regulatory knowledge — Working understanding of Medicare regulations, HIPAA, and state telehealth compliance requirements - Quality improvement experience — Track record implementing quality improvement processes to enhance clinical outcomes and operational performance - Technology implementation — Experience evaluating, selecting, and implementing care management platforms, EHRs, or related clinical systems - Builder mentality — You see the gap, you fill it, and you document how you did it so others can follow - Nimble and adaptive — You thrive in ambiguity and treat a fast-changing environment as an opportunity, not a stressor - Tech-forward — Comfortable with care management platforms, EHRs, and digital tools; quick to learn new systems - Resilient problem-solver — You don't wait for perfect conditions; you find a way - Low ego, high output — Equally comfortable owning the detail work and showing up credibly in strategic conversations **Nice-to-Have's** - Experience in a startup, pilot program, or ground-up initiative - Familiarity with value-based care or population health models - Bilingual (Spanish or other languages depending on target population) - CHW (Community Health Worker) certification - Experience with Motivational Interviewing or trauma-informed care frameworks - Background in vendor management or platform procurement ### Why This Role - Ground-floor opportunity to shape a program from day one - Close partnership with leadership — your voice will matter - Competitive compensation with growth trajectory tied to program expansion - Meaningful, mission-driven work with visible patient impact ### What We Offer  - Competitive compensation - Health, Dental, and Vision insurance - Short-term Disability and Life Insurance (100% employer-sponsored) - Long-term Disability - Supplemental Life Insurance (employee-sponsored) - 401(k) Retirement Plan - 100% Remote - Generous paid time off and 6 paid holidays