VP, Care Coordination & Navigation — Remote Builder

Advantmed; Irvine (CA); Hybrid; USD 180,000 - 260,000; Full time

Benefits offered by this job

Health insurance

Annual bonus

401k

Life Insurance

Paid Time Off

Family leave

Disability insurance

Work From Home

Wellness resources

Job summary

Advantmed is building a new Care Coordination and Benefits Navigation offering and seeks an experienced healthcare operator to lead the venture from the ground up. This builder role covers designing the operating model, creating playbooks, and standing up the technology and staffing infrastructure.

You will hire and train the initial team, drive launch through execution, and align processes with Medicare Advantage, Medicaid, and D-SNP populations, while establishing KPIs, reporting, and scalable

Qualifications

• 10+ years in healthcare operations with care coordination or population health programs.
• Strong knowledge of Medicare Advantage, Medicaid, and/or D-SNP populations.
• Experience building or scaling a healthcare service operation from scratch.
• Proven ability to develop workflows, SOPs, staffing models, and performance metrics.
• Strong understanding of member engagement in health plan contexts.
• Able to work across strategy and hands-on execution with limited delegation.
• Builder mindset: enjoys creating new operations from a blank page.

Responsibilities

• Design the end-to-end operating model. Build member intake, assessment, segmentation, care planning, navigation, referral, follow-up, and case-closure workflows from a blank page, scoped to Medicare Advantage, Medicaid, and D-SNP populations.
• Build the operating infrastructure. Author the playbooks, SOPs, scripts, decision trees, and clinical and non-clinical escalation protocols the team will run on.
• Stand up staffing and capacity. Define care coordinator and navigator staffing, caseload, and capacity models, and hire and train the initial team against them.
• Establish performance infrastructure from day one. Build training, certification, quality assurance, and performance management programs, along with the KPIs and outcomes measurement the business will be run on.
• Define the technology footprint. Set the case management and technology requirements needed to run the operation, including any build-versus-buy decisions.
• Own member engagement. Design the outreach and engagement strategies that drive participation in navigation and care coordination services.
• Take the offering to launch and scale. Sequence the build so the business moves from concept to live operation, then scales staffing, process, and technology against real client volume — with client reporting and unit economics in place from the start.

Skills

Healthcare operations

Care coordination

Population health

Workflow design

Staffing & capacity planning

Quality assurance

Performance metrics

Member engagement

Strategy to execution

Builder mindset

Job description

Advantmed is building a new Care Coordination and Benefits Navigation offering and seeks an experienced healthcare operator to lead the venture from the ground up. This builder role covers designing the operating model, creating playbooks, and standing up the technology and staffing infrastructure.

You will hire and train the initial team, drive launch through execution, and align processes with Medicare Advantage, Medicaid, and D-SNP populations, while establishing KPIs, reporting, and scalable