Description

Position Title: Clinical Manager, Advocacy and Navigation

Reporting To: Director of Member Services

Location: Chapel Hill, NC

Compensation: $80,000-$90,000 depending on experience, plus 10% bonus target and benefits

Close Date: 8/28/26

About the Role

The Clinical Manager Advocacy & Navigation Manager is responsible for providing strategic and operational leadership for a multi-channel clinical contact center (inbound/outbound calls, video calls, and asynchronous chat) and leading a multi-disciplinary call center team dedicated to delivering high-touch, compassionate, and seamless member support.This role oversees a diverse team of licensed and non-licensed healthcare professionals-such as Registered Nurses, Certified Coaches, Care Navigators, Intake Coordinators, Registered Dietitians (RDs), Clinical Exercise Physiologists (CEPs) and administrative support staff.

The ideal candidate is a licensed RD that thrives in a fast-paced contact center environment, blends clinical knowledge and operational excellence with deep empathy, and is passionate about guiding members through complex benefit structures, provider searches, and personalized care pathways. Reporting directly to the Director of Member Services, you will drive key contact center metrics (First Contact Resolution, SLA adherence, utilization, and quality) while championing an advocacy-first culture.
Key Responsibilities
Team Leadership & Operational Excellence

• Direct Supervision: Manage, coach, and support a diverse team of clinical and non-clinical staff, including Intake Coordinators, Certified Health Coaches, Registered Dietitians, Clinical Exercise Physiologists, and Nurses.
• Daily Contact Center Operations: Oversee day-to-day advocacy and navigation team, ensuring seamless handling of workflows, patient inquiries, triage support, provider searches, appointment scheduling, and care navigation.
• Performance Management: Monitor case queue health, staffing levels and scheduling to hit on Key Performance Indicators(KPIs), including average handle times (AHT), initial resolution rates, and service level agreements (SLAs), time-to-appointment, schedule utilization, and cancellation/no-show rate, without compromising care quality or member empathy.
• Interdisciplinary Collaboration: Work closely with clinical leads (Nursing, Nutrition, Exercise Science) to ensure cross-functional alignment on member care plans and clinical triage guidelines.
• Implement rapid operational adjustments to handle peak volume periods, urgent clinical surges, or system outages.

People Leadership & Team Development

• Directly supervise, coach, and mentor a multi-disciplinary team, including Nurses, Certified Coaches, Care Navigators, Intake Coordinators, Registered Dietitians (RDs), Clinical Exercise Physiologists (CEPs) and administrative support staff
• Conduct regular performance reviews, one-on-ones, and structured feedback sessions focused on metric accountability and professional growth.
• In coordination with the MS leadership support recruitment efforts, onboarding, and continuous training programs and skill-building sessions to decrease time-to-proficiency, continuously upskill the team and reduce turnover.
• Foster an engaging, high-empathy, and patient-first culture that minimizes agent burnout in a high-stress contact center environment.

Member Advocacy & Navigation Strategy

• Complex Case Escalation: Serve as the second-tier escalation point for complex member challenges, intricate benefit/claims inquiries, and high-friction provider network searches.
• Seamless Care Routing: Ensure smooth handoffs between intake teams, Well Guides, intake coordinators, and clinical specialists (Nurses, RDs, CEPs)
• Process Improvement: Identify workflow gaps and operational bottlenecks, to continuously improve member outcomes and overall satisfaction. Identify opportunities where we can enhance our navigation and advocacy capabilities.
• Maintain and update standard operating procedures (SOPs) for internal collaboration, contact routing and nurse-triage guideline
• Work with Member Services leadership to evaluate gaps in current tooling and evaluate new tools, including provider search tooling, for efficacy and efficiency.

Quality, Training & Compliance

• Quality Assurance (QA): Partner with QA to perform routine chart review and call monitoring to ensure accuracy, quality, and adherence to best practices in benefits interpretation, navigation, best-in-class coaching, and clinical/wellness guidelines.
• Regulatory Compliance: Ensure all call center practices comply with HIPAA, state healthcare regulations, and organizational privacy/security protocols.

Requirements

• 5+ years in healthcare navigation, member advocacy, telephonic triage, care/case management, or care coordination.
• 2-4+ years of direct supervisory or management experience in a clinical call center/contact center environment.
• Licensure: Active, unencumbered Registered Nurse (RN) license in North Carolina required or Licensed Clinical Social Worker (LCSW/LMSW) license required; multi-state/compact license strongly preferred given a remote, multi-state member population.
• Certification: National Board of Health and Wellness Coaches (NBHWC) preferred but not required
• Knowledge Base: Strong understanding of health plan design, benefit verification, provider network directory structures, and care management workflows.
• Cross-Functional Management: Proven track record of managing both non-clinical support staff (Intake Coordinators) and clinical professionals (Nurses, Dietitians, Exercise Physiologists, Certified Coaches).