VP, Care Management – Navigation

Advantmed

. Build the member intake, assessment, segmentation, care planning, navigation, referral, follow-up, and case-closure workflows for Medicare Advantage, Medicaid, and D-SNP populations.

Posted 9/15/2026full-timeRemote • United StatesLeadWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive experience in healthcare operations with a focus on care coordination, member navigation, and population health programs. Proven ability to build and scale healthcare service operations, develop workflows, and establish performance metrics from the ground up.

Highest-signal resume keywords

Healthcare Operations ExperienceCare Coordination OwnershipMedicare Advantage KnowledgeWorkflow DevelopmentMember Engagement Strategies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care ManagementCase ManagementPerformance MetricsQuality AssuranceTraining ProgramsSOP DevelopmentCapacity ModelingOutreach StrategiesKPI EstablishmentDecision Trees

Soft Skills

Builder MindsetStrategic ExecutionTeam LeadershipTraining and DevelopmentAdaptability

Industry Keywords

MedicaidD-SNPHealth-Plan Operating EnvironmentCare Coordination ServicesClient ReportingUnit Economics

About the role

Key responsibilities & impact

Build the member intake, assessment, segmentation, care planning, navigation, referral, follow-up, and case-closure workflows for Medicare Advantage, Medicaid, and D-SNP populations.
Author playbooks, SOPs, scripts, decision trees, and clinical and non-clinical escalation protocols.
Define care coordinator and navigator staffing, caseload, and capacity models.
Hire and train the initial team.
Build training, certification, quality assurance, and performance management programs.
Establish KPIs and outcomes measurement.
Define case management and technology requirements, including build-versus-buy decisions.
Design outreach and engagement strategies to drive participation in navigation and care coordination services.
Lead the offering from concept to launch and scale staffing, processes, and technology against client volume.
Establish client reporting and unit economics from the start.
Report to the Chief Operations Officer.

Requirements

What you’ll need

10+ years of healthcare operations experience, including direct ownership of care coordination, care management, member navigation, or population health programs.
Strong working knowledge of Medicare Advantage, Medicaid, and/or D-SNP populations and the health-plan operating environment they sit within.
Demonstrated experience building or significantly scaling a healthcare service operation - not solely managing an operation someone else designed.
Track record developing workflows, SOPs, staffing and capacity models, training and certification programs, quality assurance, and performance metrics from a limited or non-existent starting point.
Strong understanding of member engagement and outreach in a health-plan or care-coordination context.
Comfortable moving fluidly between strategy and hands-on execution - this role will not have a large team to delegate to at launch.
A genuine builder mindset: energized by creating something from a blank page rather than optimizing an existing operation.

Benefits

Comp & perks

Health Care Plan (Medical, Dental & Vision)
Annual Performance Bonus
Retirement Plan (401k, IRA)
Life Insurance (Basic, Voluntary & AD&D)
Paid Time Off (Vacation, Sick & Public Holidays)
Family Leave (Maternity, Paternity)
Short Term & Long Term Disability
Work From Home
Wellness Resources