Manager, SDOH

Monogram Health

. Lead Monogram Health’s Care Navigation function and Social Determinants of Health initiatives .

Posted 11/6/2026full-timeRemote • Tennessee • United StatesMid-LevelSenior💰 $88,880 - $115,544 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Care Navigation and Social Determinants of Health initiatives, with a strong focus on team management, patient engagement, and operational performance improvement. Proficient in analyzing social barriers and implementing strategies to enhance resource utilization and health outcomes.

Highest-signal resume keywords

Care Navigation LeadershipTeam ManagementSocial Determinants Of HealthEHR/EMR ProficiencyPatient Engagement Strategies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Social WorkHealthcare AdministrationPublic HealthCare ManagementPopulation HealthData AnalysisPerformance EvaluationResource CoordinationQuality MetricsReferral Management

Soft Skills

Communication SkillsRelationship BuildingCultural CompetencePrioritizationCoaching

Tools & Technologies

EHR SoftwareEMR SoftwareMicrosoft Office Suite

Industry Keywords

MedicaidMedicareValue-Based CareHealth EquityPatient Outcomes

About the role

Key responsibilities & impact

Lead Monogram Health’s Care Navigation function and Social Determinants of Health initiatives
Manage, coach, and develop a team of Care Navigators
Establish productivity, quality, engagement, and documentation expectations
Conduct performance reviews, audits, coaching sessions, and career development planning
Monitor caseloads and resource allocation for timely patient outreach and follow-up
Ensure consistent execution of Care Navigator workflows, policies, and best practices
Serve as an escalation point for complex patient needs, resource barriers, and challenging social situations
Partner with Talent Acquisition and Operations leaders on hiring, onboarding, and workforce planning
Oversee outreach, engagement, education, and resource coordination activities
Ensure accurate screening and documentation of social determinants of health needs
Monitor referrals and follow-up to improve successful resource connections
Develop processes to increase patient participation and reduce engagement barriers
Ensure culturally responsive, person-centered support aligned with Monogram’s care model
Evaluate navigator effectiveness through patient outcomes, engagement rates, and quality metrics
Lead efforts to identify and address social barriers affecting health outcomes
Monitor SDoH screening, referral management, and closed-loop referral processes
Analyze trends in food insecurity, housing instability, transportation barriers, financial hardship, utility assistance, social isolation, healthcare access, and health literacy
Develop strategies to improve resource utilization and social needs resolution
Collaborate with market and clinical leadership on health equity initiatives

Requirements

What you’ll need

Bachelor’s degree in Social Work, Healthcare Administration, Public Health, or related field
Master’s degree preferred
Minimum of three (3) years of experience in social services, care management, population health, or healthcare operations
Experience managing teams and driving operational performance to improve team performance, patient engagement, and patient outcomes
Demonstrated communication and relationship building skills
Comfort working with diverse populations and complex social needs
Ability to manage multiple priorities in a fast-paced environment
Proficient in EHR/EMR software, Microsoft Office Suite, and data analysis
Experience working with Medicaid, Medicare, or value-based care populations preferred

Benefits

Comp & perks

Medical, dental, and vision insurance
Employee assistance program
Employer-paid and voluntary life insurance
Disability insurance
Health and flexible spending accounts
Competitive compensation
401k with employer match
Financial wellness resources
20 PTO days
7 paid holidays
1 floating day
Paid parental leave
Work life assistance resources
Physical wellness perks
Mental health support
Employee referral program
BenefitHub employee discounts