Clinical Program Manager, Care Navigation, US Remote

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