Vice President, Care Management & Navigation

Vice President, Care Management & Navigation

About the Company

Innovative healthcare technology (HealthTech) company

Industry
Hospital & Health Care

Type
Privately Held

Founded
2005

Employees
1001-5000

Categories

• Health Care

Specialties

• risk adjustment
• quality improvement
• medical record review
• medical record coding
• health assessments
• and risk adjustment analytics

About the Role

The Company is seeking a VP for Care Management and Navigation to spearhead the development of a new healthcare offering. This is a pivotal role focused on building the business from the ground up, with a strong emphasis on designing the operating model, establishing workflows, and creating the necessary infrastructure for care coordination and benefits navigation. The successful candidate will be responsible for all aspects of the build, including authoring playbooks, defining staffing and capacity models, and setting up performance and technology requirements. A key aspect of the role is to own member engagement, design outreach strategies, and take the offering from concept to a live, scalable operation. Candidates for the VP position should have a minimum of 10 years' of healthcare operations experience, with a proven track record in care coordination, care management, member navigation, or population health programs. Essential qualifications include a strong understanding of Medicare Advantage, Medicaid, and D-SNP populations, as well as experience in building or significantly scaling a healthcare service operation. The role requires a hands-on approach, the ability to move between strategy and execution, and a genuine builder mindset. The VP will be expected to design and implement all necessary processes, from member intake to case closure, and to establish the performance infrastructure from day one.

Hiring Manager Title
Chief Operations Officer

Functions

• Medical Care/Hospital Administration
• Operations