Care Management Navigator

Homeward is rearchitecting the delivery of health and care in partnership with communities everywhere, starting in rural America. Today, 60 million Americans living in rural communities are facing a crisis of access to care. In the U.S. healthcare system, rural Americans experience significantly poorer clinical outcomes. This trend is rapidly accelerating as rural hospitals close and physician shortages increase, exacerbating health disparities. In fact, Americans living in rural communities suffer a mortality rate 23 percent higher than those in urban communities, in part because of the lack of access to quality care.

Our vision is care that enables everyone to achieve their best health. So, we’re creating a new healthcare delivery model that is purpose-built for rural America and directly addresses the issues that have historically limited access and quality. Homeward supports Medicare-eligible beneficiaries by partnering with health plans, providers, and communities to align incentives – taking full financial accountability for clinical outcomes and the total cost of care across rural counties.

As a public benefit corporation and Certified B Corp™, Homeward’s mission and business model are aligned to address the healthcare, economic, and demographic challenges that make it challenging for rural Americans to stay healthy. Our Homeward Navigation™ platform uses advanced analytics to connect members to the right care and local resources that address social determinants of health and improve holistic health outcomes. Since many rural communities lack adequate clinical capacity, Homeward also employs care teams that supplement local practices and reach people who cannot otherwise access care.

Homeward is co-founded by a leadership team that defined and delivered Livongo’s products, and backed most recently by a $50 million series B co-led by Arch Ventures and Human Capital, with participation from General Catalyst for a total of $70 million in funding. With this leadership team and funding, Homeward is committed to bringing high-quality healthcare to rural communities in need.

The Opportunity

We’re seeking a Care Management Navigator to be a critical member of our care team, working telephonically and virtually to support Medicare-eligible members across the care continuum. This role focuses on transitional and chronic care management, with a strong emphasis on proactive outreach, education, and addressing social determinants of health.

This is a great opportunity for a high-touch care professional excited about working in a fast-paced, mission-driven environment. You will work closely with RN Care Managers, providers, and community organizations to coordinate care, build patient engagement, and ensure members achieve their best possible health.

What You’ll Do

• Support patients through transitions of care, particularly post-hospitalization or post-SNF, by coordinating follow-up appointments, confirming discharge plans, and addressing barriers.
• Conduct telephonic outreach to high-risk members to:
• Assess needs, including medical, behavioral, and social challenges.
• Reinforce care plans and promote follow-up with primary and specialty care.
• Encourage engagement in chronic condition self-management and preventive services.
• Identify and help resolve gaps in care such as overdue labs, screenings, or refills.
• Partner with RN Care Managers and other clinical staff to escalate concerns that require nursing-level assessment or intervention.
• Help patients access transportation, food, housing, or community-based services as needed.
• Document all interactions and navigation outcomes in the EHR.
• Assist in tracking and supporting quality measures including HEDIS, Stars, and other performance goals.
• Participate in regular interdisciplinary meetings, trainings, and performance improvement initiatives.
  
  

What You Bring

Education: Completion of a Medical Assistant program OR equivalent healthcare training/certification. CHW certification is a plus.

Experience:

• At least two years in a high-touch, patient-facing or telephonic role.
• Familiarity with Medicare and managing chronic conditions preferred.
• Strong verbal communication skills and ability to engage patients remotely with empathy, clarity, and motivation techniques.
• Tech-savvy with comfort using EHR systems and connected health devices.
• Highly organized, self-directed, and able to work independently in a remote setting.
• Passion for rural health equity and commitment to whole-person care.

Bonus Points

• Prior work in value-based care or care coordination programs.
• Experience in transitional care, SDoH navigation, or quality performance support.
• Fluency in motivational interviewing or health coaching strategies.

What Shapes Homeward

• Deep commitment to one another, the people and communities we serve, and to providing care that enables everyone to achieve their best health
• Compassion and empathy
• Curiosity and an eagerness to listen
• Drive to deliver high-quality experiences, clinical care, and cost-effectiveness
• Strong focus on the sustainability of our business and scalability of our services to maximize our reach and impact
• Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view
• Taking our mission and business seriously, but not taking ourselves too seriously– having fun as we build!

Benefits

• Medical, dental, and vision insurance with 100% of monthly premium covered for employees
• Competitive salary and possible equity grant
• Supplemental performance bonus opportunities
• Relocation and travel reimbursement
• Loan repayment support
• Company-sponsored 401k plan + match
• Generous paid time off
• Comprehensive training provided

The base salary range for this position is $21-24 hourly. Compensation may vary outside of this range depending on a number of factors, including a candidate’s qualifications, skills, location, competencies, and experience. Base pay is one part of the Total Package that is provided to compensate and recognize employees for their work at Homeward Health. This role is eligible for an annual bonus, stock options, as well as a comprehensive benefits package.

At Homeward, we believe that a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you do not have experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams.

Homeward is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Homeward is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.