Patient Navigation Leader: Drive Access & Compliance

ChenMed LLC; United States; On-site; USD 77,000 - 110,000; Full time

Job summary

ChenMed LLC is seeking a Manager, Patient Navigation to lead day-to-day operations of a high-compliance call center. You will supervise Tier 1 and Tier 2 staff, oversee intake across three workstreams, and ensure all tickets are triaged and closed per CMS standards.

You will partner with a borrowed Medical Director for Tier 3 sign-off, monitor performance metrics, and drive improvements to patient navigation processes in a Medicare Advantage environment.

Qualifications

• BA/BS in Healthcare Administration, Business or closely related field.
• 3–5 years of healthcare operations, call center management, or patient services experience.
• Experience with Medicare Advantage or managed care is preferred.
• Experience partnering with clinical staff in a matrixed or borrowed-resource model is a plus.

Responsibilities

• Directs day-to-day operations of the Patient Navigation function and staffing.
• Oversees intake and triage across multiple workstreams, ensuring compliant, closed-loop resolutions.
• Performs call monitoring and audits to ensure CMS delegation oversight and non-discrimination rules.
• Maintains governance with clear maker/checker controls for high-impact cases.
• Coordinates with Medical Director for Tier 3 clinical sign-off and capacity planning.
• Tracks and reports performance metrics to senior leadership on cadence.
• Identifies systemic issues and provides data-driven recommendations.

Skills

Call center management

CMS compliance

Data analysis

Coaching & training

Cross-functional collaboration

HIPAA compliance

Excel proficiency

English fluency

Education

BA/BS in Healthcare Administration or related field

Master's degree a plus

Tools

CRM software

Case-management software

Microsoft Office

Job description

ChenMed LLC is seeking a Manager, Patient Navigation to lead day-to-day operations of a high-compliance call center. You will supervise Tier 1 and Tier 2 staff, oversee intake across three workstreams, and ensure all tickets are triaged and closed per CMS standards.

You will partner with a borrowed Medical Director for Tier 3 sign-off, monitor performance metrics, and drive improvements to patient navigation processes in a Medicare Advantage environment.