Responsable Comercial de Tienda
Clicars
Care Navigation Nurse Manager
Gravie
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $96,000 - $160,000 per year
Job Level
SeniorLead
About the role
- Oversee the day-to-day operations of the Care Navigation team, ensuring consistent delivery of high-quality service and support.
- Monitor team performance, providing coaching, feedback, and professional development to drive continuous improvement.
- Foster a collaborative, supportive, and high-performing team culture aligned with Gravie’s values.
- Oversee policy development and management within Care Navigation to ensure consistent processes and standards.
- Lead outreach efforts that reduce barriers to care and improve access to essential services.
- Enhance member satisfaction through proactive communication, education, and advocacy.
- Ensure members receive coordinated, personalized care navigation that supports positive health outcomes.
- Maintain compliance with all regulatory, accreditation, and internal policy standards.
- Track, analyze, and report measurable outcomes to demonstrate program value and identify opportunities for improvement.
- Collaborate with leadership to design, implement, and refine workflows, policies, and quality assurance processes.
- Partner with Stop Loss, Underwriting, Utilization Management, and Vendor Management teams to align clinical strategy with financial risk mitigation.
- Support the proactive identification and management of High Cost Claimants (HCCs) through claims analysis, predictive modeling, and clinical data review.
- Track and report HCC management outcomes including cost savings, member experience, and clinical quality.
- Build and maintain strong relationships with internal and external stakeholders to ensure alignment and optimize program effectiveness.
- Identify trends, gaps, and process inefficiencies; recommend and implement solutions to enhance operational performance and care quality.
- Leverage data and analytics to inform strategic decisions and evaluate program impact.
- Drive innovation within Care Navigation to improve outcomes, satisfaction, and cost control
Requirements
- Active, unrestricted Registered Nurse (RN) license required
- Bachelor’s degree in Nursing (BSN) preferred
- 8+ years of nursing experience, including at least 3 years in a leadership or management role
- Experience in a health plan, third-party administrator (TPA), or managed care organization strongly preferred
- Proven track record of managing teams and driving performance in clinical or care coordination settings
- Strong organizational and project management skills.
- Excellent relationship-building and communication abilities.
- Proficiency in data analysis and vendor performance dashboards
- Knowledge of healthcare quality, utilization management, and medical cost containment.
- Comfortable working in a fast-paced, evolving environment.
Benefits
- Health insurance
- 401k program
- Flexible PTO
- Paid parental leave (up to 16 weeks)
- Paid holidays
- Cell phone reimbursement
- Transportation perks
- Education reimbursement
- Paid paw-ternity leave (1 week)
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
data analysisclaims analysispredictive modelingclinical data reviewcare coordinationhealthcare qualityutilization managementmedical cost containmentteam managementpolicy development
Soft skills
coachingfeedbackprofessional developmentcollaborationrelationship-buildingcommunicationorganizational skillsproject managementinnovationproblem-solving
Certifications
Registered Nurse (RN) license
