Patient Navigation Operations Manager

chenmed; United States; On-site; USD 90,000 - 130,000; Full time

Job summary

ChenMed is seeking a Manager, Patient Navigation to lead the day-to-day operations of our centralized, high-compliance call center. You will supervise Tier 1 navigators and Tier 2 RN/Licensed Social Worker staff, ensuring all interactions are triaged, worked, and documented to CMS delegation standards.

You will partner with the Medical Director for Tier 3 sign-offs and drive performance reporting across volume, conversion, staffing, and compliance metrics to senior leadership.

Qualifications

• Experience managing a healthcare call center or patient-facing operations.
• Knowledge of CMS Medicare Advantage compliance concepts.
• Ability to train and audit staff against CMS requirements.

Responsibilities

• Manages day-to-day operations of the Patient Navigation function, including staffing, scheduling, and workload distribution across Tier 1 and Tier 2 staff.
• Oversees intake and triage across in-scope workstreams, ensuring tickets are routed, worked, and documented to a closed-loop standard.
• Conducts call monitoring and documentation audits to ensure CMS delegation-oversight compliance.
• Implements maker/checker controls for cases with panel impact or clinical determination.
• Coordinates Tier 3 clinical sign-off with the Medical Director and manages review cadence.
• Tracks and reports team performance against volume, conversion, staffing, and compliance metrics to leadership.
• Escalates systemic operational issues with data-driven recommendations.
• Coaches and develops staff; leads training on process, script, and compliance updates.
• Collaborates with other departments on hand-offs for tickets outside Phase 1 scope.

Skills

Call center management

Healthcare operations

CMS Medicare compliance

Team leadership

Staff coaching

Data-driven decisions

Job description

ChenMed is seeking a Manager, Patient Navigation to lead the day-to-day operations of our centralized, high-compliance call center. You will supervise Tier 1 navigators and Tier 2 RN/Licensed Social Worker staff, ensuring all interactions are triaged, worked, and documented to CMS delegation standards.

You will partner with the Medical Director for Tier 3 sign-offs and drive performance reporting across volume, conversion, staffing, and compliance metrics to senior leadership.