Clinical Program Manager, Care Navigation, US Remote

About CarewellCarewell 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 RoleThis 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 DoProgram Leadership & OperationsDesign and implement care navigation workflows, SOPs, clinical standards, and program parameters from the ground upLead 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 teamConduct performance reviews, coaching, and corrective action as neededDefine and implement quality improvement processes to drive continuous program enhancementEvaluate, select, and implement care management technology, EHR platforms, and digital toolsManage vendor relationships and oversee system integration and optimizationDevelop and execute within a clinical program budgetServe as a culture carrier and clinical role model as the team scalesClinical Oversight & QualityEstablish and monitor documentation standards, clinical behavioral standards, and performance expectationsEnsure regulatory compliance with Medicare billing requirements, HIPAA, state telehealth laws, and other applicable regulationsDevelop clinical risk management protocols and escalation pathwaysOversee appropriate documentation across all systems to support compliance and billing accuracyEnsure time-based documentation standards are met (start time, stop time, duration tracking for monthly minute aggregation)Measurement, Reporting & AccountabilityDevelop reporting frameworks for clinical outcomes, quality metrics, and compliance indicatorsDeliver clinical outcomes reporting to internal stakeholders, providers, and payersTrack and report on program KPIs (see below)Use data insights to inform strategic decisions and drive program iterationDirect Patient Care (Initial Launch Phase)Deliver hands-on care navigation services to a limited caseload during program launch to inform workflow designConduct SDOH screenings and connect patients to community resourcesBuild trusted relationships with patients, families, and care teamsModel best practices for documentation and clinical excellenceKPIs You're Responsible ForClinical PerformanceClinical team productivity (encounters per clinician, time utilization)Clinical outcomes (disease management metrics, care plan adherence, hospitalization/readmission rates)Care gap closure rateEscalation pattern analysis (volume trends, root cause, training signal identification)Patient NPS and satisfaction scoresPatient EngagementProgram Quality & ComplianceDocumentation compliance ratesClinical behavioral and performance standards adherenceClinical protocol adoption, consistency across pods, and iteration cadenceSafety event tracking and response timesRegulatory audit readinessOperational EfficiencyAverage time-to-resolution for patient needsCaseload capacity and coverage relative to patient volumeResource utilization ratesCost per patient servedRevenue cycle metrics (as applicable)Team & GrowthSupervisor performance and developmentTeam scaling velocity and time-to-productivity for new hiresStaff retention and engagementReporting & OutcomesTimely delivery of internal, provider, and payer-facing clinical reportsQuality of reporting frameworks and data integrityWho You AreMust-Have RequirementsLicensed for multi-state practice — Active Nurse Licensure Compact (NLC) multistate license; prepared to obtain licensure in non-NLC states as program expandsClinical credentials — LVN preferred; RN considered for candidates with demonstrated leadership experience and genuine appetite for building and managing programsMedicare 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 rolesTelehealth expertise — Demonstrated ability to deliver remote care management, build rapport, and coordinate care via telephonic and digital toolsManagement experience — Proven track record leading, mentoring, or supervising clinical or operational teamsSDOH fluency — Comfortable navigating social determinants and connecting patients to resources across complex systemsRegulatory knowledge — Working understanding of Medicare regulations, HIPAA, and state telehealth compliance requirementsQuality improvement experience — Track record implementing quality improvement processes to enhance clinical outcomes and operational performanceTechnology implementation — Experience evaluating, selecting, and implementing care management platforms, EHRs, or related clinical systemsBuilder mentality — You see the gap, you fill it, and you document how you did it so others can followNimble and adaptive — You thrive in ambiguity and treat a fast-changing environment as an opportunity, not a stressorTech-forward — Comfortable with care management platforms, EHRs, and digital tools; quick to learn new systemsResilient problem-solver — You don't wait for perfect conditions; you find a wayLow ego, high output — Equally comfortable owning the detail work and showing up credibly in strategic conversationsNice to HaveExperience in a startup, pilot program, or ground-up initiativeFamiliarity with value-based care or population health modelsBilingual (Spanish or other languages depending on target population)CHW (Community Health Worker) certificationExperience with Motivational Interviewing or trauma-informed care frameworksBackground in vendor management or platform procurementWhy This RoleGround-floor opportunity to shape a program from day oneClose partnership with leadership — your voice will matterCompetitive compensation with growth trajectory tied to program expansionMeaningful, mission-driven work with visible patient impactWhat We Offer Competitive compensationHealth, Dental, and Vision insuranceShort-term Disability and Life Insurance (100% employer-sponsored)Long-term DisabilitySupplemental Life Insurance (employee-sponsored)401(k) Retirement Plan100% RemoteGenerous paid time off and 6 paid holidays