VP, Care Management & Navigation
Advantmed · United States · 1 mo ago
RemoteRemoteHealthcareFull-time
We need to output HTML fragment with sections: About the role? Actually the posting includes "About Advantmed" (company description) and "Position Summary" etc. We need to use headings for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We must only include sections that have real specific content. The posting includes company description (About Advantmed) but not "About the role". However we could treat "About Advantmed" as "About the role"? The instruction: use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we should map content to these headings if appropriate. The posting includes "About Advantmed" (company overview) maybe fits under "About the role"? Not exactly but could be considered about the role context. However we must not repeat job title as heading. There's no explicit job title given; it's VP, Care Management & Navigation. We could include a short paragraph about the role under "About the role". The posting includes "Position Summary" which describes the role. That could go under "About the role". Then responsibilities are listed under "Responsibilities & Strategic Goals". That's responsibilities. Requirements are listed under "Essential Qualifications". That's requirements/qualifications. Benefits are listed under "Benefits". Pay: they mention compensation will be determined based on experience; not specific numbers, so we should NOT include Pay section because it's not specific (just "determined based on experience"). Schedule: they mention Remote within the United States, Work From Home under benefits. That's schedule info (remote). Could include Schedule section with remote work. But we need to ensure we only include sections with real specific content. The posting says "Location - Remote within the United States" and under Benefits includes "Work From Home". So we can include Schedule section with remote work. Pay: they say "Compensation for this role will be determined based on the selected candidate's experience and qualifications." That's vague; we should not include Pay section because it's not specific. Benefits: they list many benefits; we can include Benefits section.
Skills: not explicitly listed; maybe we can omit Skills section.
Qualifications: we have Essential Qualifications; could map to Qualifications heading. Requirements maybe same as Qualifications? The instruction says we can have both Requirements and Qualifications sections if content. We have responsibilities, requirements (essential qualifications). Could also include Qualifications as same content? Better to have Requirements for the list of essential qualifications, and Qualifications maybe for "Strong working knowledge..." etc. But to avoid duplication, we can put the list under Requirements and maybe Qualifications omitted. However we need to preserve all substantive information; we can put the essential qualifications list under Requirements. Qualifications could be omitted if no distinct content. But we might still include Qualifications heading with same list? That would be duplication. Better to follow typical structure: Responsibilities, Requirements, Benefits. Also About the role (position summary). We'll omit Qualifications, Skills, Pay, Schedule unless we have content. Schedule we have remote location; we can include Schedule section with remote work.
Thus sections:
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It says e.g., not exclusive. So we could add other headings if needed, but better to stick to those. We can include company description in About the role paragraph.
Thus About the role paragraph will contain both company overview and position summary.
Let's craft:
About Advantmed: healthcare services company headquartered in Irvine, California, serving primarily health plans that participate in government-sponsored programs. The Company operates three lines of business: medical record retrieval; medical record review and coding; and in-home health assessments. Together these support health plans across risk adjustment, HEDIS, quality reporting, and member care — with a substantial delivery organization in Ahmedabad, India supporting the U.S. operation. In-home health assessments are the Company's newest line of business and its fastest growing. Launched in 2017 and scaled significantly from 2024, the business today deploys a network of approximately 500 nurse practitioners and clinicians across roughly 32 states on behalf of 10 to 12 health-plan clients. Members are engaged through a combination of outbound telephony, text, direct mail, and a self-scheduling portal, and are seen in their homes by a clinician who completes a comprehensive assessment on the plan's behalf. In-home health assessment is where Advantmed sees its largest opportunity, and the Company has invested accordingly. Recent additions to the leadership team include a Chief Revenue Officer and a Senior Vice President of Client Success, both having previously served at Signify Health, and a Senior Vice President of Product Management with prior health-plan experience at SCAN. The Company is planning for in-home assessment volume to double, and potentially triple, over the next two years, and is actively investing in member-engagement and care-coordination capabilities to support that growth. Advantmed was founded by Chief Executive Officer Akash Patel and Chief Operating Officer Jignesh ("Jig") Patel who currently oversees operations across all three lines of business.
Position Summary: Advantmed is building a new healthcare offering focused on Care Coordination and Benefits Navigation and is seeking an experienced healthcare operator to build and lead the business from the ground up. This is a builder role, not a role overseeing an established operation: the mandate is to design the operating model, build the playbooks, stand up the technology and staffing infrastructure, hire and train the initial team, and take the offering from launch through execution.
We'll combine.
Responsibilities list from "Responsibilities & Strategic Goals": bullet points:
- 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
Requirements list from "Essential Qualifications":
- 10+ years of healthcare operations experience, including direct ownership of care coordination, care management, member navigation, or population health programs
- Strong working knowledge of Medicare Advantage, Medicaid, and/or D-SNP populations and the health-plan operating environment they sit within
- Demonstrated experience building or significantly scaling a healthcare service operation — not solely managing an operation someone else designed
- Track record developing workflows, SOPs, staffing and capacity models, training and certification programs, quality assurance, and performance metrics from a limited or non-existent starting point
- Strong understanding of member engagement and outreach in a health-plan or care-coordination context
- Comfortable moving fluidly between strategy and hands-on execution — this role will not have a large team to delegate to at launch
- A genuine builder mindset: energized by creating something from a blank page rather than optimizing an existing operation
Benefits list:
- Health Care Plan (Medical, Dental & Vision)
- Annual Performance Bonus
- Retirement Plan (401k, IRA)
- Life Insurance (Basic, Voluntary & AD&D)
- Paid Time Off (Vacation, Sick & Public Holidays)
- Family Leave (Maternity, Paternity)
- Short Term & Long Term Disability
- Work From Home
- Wellness Resources
Schedule: Remote within the United States (Work From Home). Could note location.
Now produce HTML fragment.
We must not include markdown fences. Just raw HTML.
Let's craft:
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we should map content to these headings if appropriate. The posting includes "About Advantmed" (company overview) maybe fits under "About the role"? Not exactly but could be considered about the role context. However we must not repeat job title as heading. There's no explicit job title given; it's VP, Care Management & Navigation. We could include a short paragraph about the role under "About the role". The posting includes "Position Summary" which describes the role. That could go under "About the role". Then responsibilities are listed under "Responsibilities & Strategic Goals". That's responsibilities. Requirements are listed under "Essential Qualifications". That's requirements/qualifications. Benefits are listed under "Benefits". Pay: they mention compensation will be determined based on experience; not specific numbers, so we should NOT include Pay section because it's not specific (just "determined based on experience"). Schedule: they mention Remote within the United States, Work From Home under benefits. That's schedule info (remote). Could include Schedule section with remote work. But we need to ensure we only include sections with real specific content. The posting says "Location - Remote within the United States" and under Benefits includes "Work From Home". So we can include Schedule section with remote work. Pay: they say "Compensation for this role will be determined based on the selected candidate's experience and qualifications." That's vague; we should not include Pay section because it's not specific. Benefits: they list many benefits; we can include Benefits section.
Skills: not explicitly listed; maybe we can omit Skills section.
Qualifications: we have Essential Qualifications; could map to Qualifications heading. Requirements maybe same as Qualifications? The instruction says we can have both Requirements and Qualifications sections if content. We have responsibilities, requirements (essential qualifications). Could also include Qualifications as same content? Better to have Requirements for the list of essential qualifications, and Qualifications maybe for "Strong working knowledge..." etc. But to avoid duplication, we can put the list under Requirements and maybe Qualifications omitted. However we need to preserve all substantive information; we can put the essential qualifications list under Requirements. Qualifications could be omitted if no distinct content. But we might still include Qualifications heading with same list? That would be duplication. Better to follow typical structure: Responsibilities, Requirements, Benefits. Also About the role (position summary). We'll omit Qualifications, Skills, Pay, Schedule unless we have content. Schedule we have remote location; we can include Schedule section with remote work.
Thus sections:
About the role
Position Summary ...
Responsibilities
- ... list items from Responsibilities & Strategic Goals
Requirements
- ... list items from Essential Qualifications
Benefits
- ... list benefits
Schedule
Remote within the United States (Work From Home)
We must not include any boilerplate like EEO etc. The posting didn't have that. We need to preserve all substantive information: company description (About Advantmed) also needs to be included somewhere. Where to put? Could be part of About the role? Or we could add another section like "About the Company" but not allowed headings list. However we could incorporate company description into About the role paragraph as context. The instruction: "Use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It says e.g., not exclusive. So we could add other headings if needed, but better to stick to those. We can include company description in About the role paragraph.
Thus About the role paragraph will contain both company overview and position summary.
Let's craft:
About Advantmed: healthcare services company headquartered in Irvine, California, serving primarily health plans that participate in government-sponsored programs. The Company operates three lines of business: medical record retrieval; medical record review and coding; and in-home health assessments. Together these support health plans across risk adjustment, HEDIS, quality reporting, and member care — with a substantial delivery organization in Ahmedabad, India supporting the U.S. operation. In-home health assessments are the Company's newest line of business and its fastest growing. Launched in 2017 and scaled significantly from 2024, the business today deploys a network of approximately 500 nurse practitioners and clinicians across roughly 32 states on behalf of 10 to 12 health-plan clients. Members are engaged through a combination of outbound telephony, text, direct mail, and a self-scheduling portal, and are seen in their homes by a clinician who completes a comprehensive assessment on the plan's behalf. In-home health assessment is where Advantmed sees its largest opportunity, and the Company has invested accordingly. Recent additions to the leadership team include a Chief Revenue Officer and a Senior Vice President of Client Success, both having previously served at Signify Health, and a Senior Vice President of Product Management with prior health-plan experience at SCAN. The Company is planning for in-home assessment volume to double, and potentially triple, over the next two years, and is actively investing in member-engagement and care-coordination capabilities to support that growth. Advantmed was founded by Chief Executive Officer Akash Patel and Chief Operating Officer Jignesh ("Jig") Patel who currently oversees operations across all three lines of business.
Position Summary: Advantmed is building a new healthcare offering focused on Care Coordination and Benefits Navigation and is seeking an experienced healthcare operator to build and lead the business from the ground up. This is a builder role, not a role overseeing an established operation: the mandate is to design the operating model, build the playbooks, stand up the technology and staffing infrastructure, hire and train the initial team, and take the offering from launch through execution.
We'll combine.
Responsibilities list from "Responsibilities & Strategic Goals": bullet points:
- 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
Requirements list from "Essential Qualifications":
- 10+ years of healthcare operations experience, including direct ownership of care coordination, care management, member navigation, or population health programs
- Strong working knowledge of Medicare Advantage, Medicaid, and/or D-SNP populations and the health-plan operating environment they sit within
- Demonstrated experience building or significantly scaling a healthcare service operation — not solely managing an operation someone else designed
- Track record developing workflows, SOPs, staffing and capacity models, training and certification programs, quality assurance, and performance metrics from a limited or non-existent starting point
- Strong understanding of member engagement and outreach in a health-plan or care-coordination context
- Comfortable moving fluidly between strategy and hands-on execution — this role will not have a large team to delegate to at launch
- A genuine builder mindset: energized by creating something from a blank page rather than optimizing an existing operation
Benefits list:
- Health Care Plan (Medical, Dental & Vision)
- Annual Performance Bonus
- Retirement Plan (401k, IRA)
- Life Insurance (Basic, Voluntary & AD&D)
- Paid Time Off (Vacation, Sick & Public Holidays)
- Family Leave (Maternity, Paternity)
- Short Term & Long Term Disability
- Work From Home
- Wellness Resources
Schedule: Remote within the United States (Work From Home). Could note location.
Now produce HTML fragment.
We must not include markdown fences. Just raw HTML.
Let's craft:
About the role
About Advantmed: Advantmed is a healthcare services company headquartered in Irvine, California, serving primarily health plans that participate in government-sponsored programs. The Company operates three lines of business: medical record retrieval; medical record review and coding; and in-home health assessments. Together these support health plans across risk adjustment, HEDIS, quality reporting, and member care — with a substantial delivery organization in Ahmedabad, India supporting the U.S. operation. In-home health assessments are the Company's newest line of business and its fastest growing. Launched in 2017 and scaled significantly from 2024, the business today deploys a network of approximately 500 nurse practitioners and clinicians across roughly 32 states on behalf of 10 to 12 health-plan clients. Members are engaged through a combination of outbound telephony, text, direct mail, and a self-scheduling portal, and are seen in their homes by a clinician who completes a comprehensive assessment on the plan's behalf. In-home health assessment is where Advantmed sees its largest opportunity, and the Company has invested accordingly. Recent additions to the leadership team include a Chief Revenue Officer and a Senior Vice President of Client Success, both having previously served at Signify Health, and a Senior Vice President of Product Management with prior health-plan experience at SCAN. The Company is planning for in-home assessment volume to double, and potentially triple, over the next two years, and is actively investing in member-engagement and care-coordination capabilities to support that growth. Advantmed was founded by Chief Executive Officer Akash Patel and Chief Operating Officer Jignesh ("Jig") Patel who currently oversees operations across all three lines of business. Position Summary: Advantmed is building a new healthcare offering focused on Care Coordination and Benefits Navigation and is seeking an experienced healthcare operator to build and lead the business from the ground up. This is a builder role, not a role overseeing an established operation: the mandate is to design the operating model, build the playbooks, stand up the technology and staffing infrastructure, hire and train the initial team, and take the offering from launch through execution.
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