Jobs Companies Advantmed VP, Care Management & Navigation

Sobre este puesto de VP, Care Management & Navigation en Advantmed

Advantmed · Remoto · United States

About Advantmed

Advantmed is a healthcare services company headquartered in Irvine, California, serving health plans that participate in government-sponsored programs. The Company operates four lines of business: medical record retrieval; medical record review and coding; release of information; and in-home health assessments. Together these support health plans across risk adjustment, HEDIS and 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 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 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 whom join from Signify Health, and a Senior Vice President of Product 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 the member-engagement technology and care-coordination capability required to support that growth.

 

Advantmed was founded by Chief Executive Officer Akash Patel and Chief Operating Officer Jignesh (“Jig”) Patel, PharmD, who oversees operations across all four lines of business. The Company added a Chief Revenue Officer and a Chief Medical Officer in March 2026.

About Webster Equity Partners

Founded in 2003 and headquartered in Waltham, Massachusetts, Webster Equity Partners is a private equity firm pursuing high-impact growth strategies in healthcare, investing in purpose-driven, patient-centric organizations that deliver strong clinical care and broad access. Webster manages $10.1 billion in assets as of December 31, 2025, has completed more than 370 platform and add-on investments over the firm’s history, and raised $1.8 billion for its sixth fund in 2026 - its largest to date. The firm invests as a control investor and is typically the first institutional capital into a business, partnering with management and its team of Webster Operating Executives to build companies toward $100 million or more in EBITDA through a combination of organic growth and acquisition. Webster recapitalized Advantmed in February 2025; Brooke Private Equity took a minority position in the Company in May 2026.

 

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.

Key Relationships

  • Reports to: Chief Operations Officer
  • Location: Remote within the United States
  • Team at launch: Building out Team

VP, Care Management & Navigation

Responsibilities & Strategic Goals

This is a zero-to-one build. The VP owns the design, launch, and scaling of the Care Coordination and Benefits Navigation offering - from operating model and workflows through staffing, technology, and performance measurement - and is accountable for taking it from concept to a functioning, measurable business.

  • 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

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

Compensation

  • Compensation for this role will be determined based on the selected candidate's experience and qualifications.
    • 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
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Sobre Advantmed

Advantmed is a privately held company founded in 2005. The organization initially focused on record retrieval but has evolved into an innovative healthcare information management company that helps health plans and Managed Care Organizations optimize revenue and improve quality outcomes. Our mission is to improve the healthcare system by ensuring appropriate, quality care and eliminating unnecessary costs. We accomplish this by providing a cost-effective suite of capabilities tailored to the unique needs of our clients, including NCQA-certified HEDIS® measure software, risk analytics, medical record retrieval, medical record abstraction, risk adjustment coding, data validation, prospective assessments, and provider education.

Our strategy reflects our flexibility and commitment to meeting our clients' evolving needs. We work closely with our clients to understand their concerns, requirements, strategic objectives, and infrastructure so that we can support them accordingly. Our foundational principles are accuracy, efficiency, and transparency. Our solutions are designed to be user-friendly and flexible.

We see ourselves as an extension of our clients’ internal teams, which allows us to work to advance our solutions and provide support for their growing business needs. Understanding how our clients use our products and services fuels our product development road map, especially in terms of technology as we continually work to improve our client portal. In addition, we regularly monitor statutory and regulatory changes from CMS, HHS, NCQA, and others.

The Advantmed leadership team is composed of seasoned healthcare veterans, with extensive quality and risk adjustment expertise. The leadership team oversees a global staff of over 1,800 employees. Notably, we are HITRUST certified, and all data resides within the United States.

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