Head of Care Management Offering

Head of Care Management (RN)
Pythagoras AI | Remote| Full-time

About Pythagoras AI

Pythagoras AI builds and operates Clara, an AI care agent that conducts clinical and administrative conversations by voice and text on behalf of healthcare organizations. Clara handles inbound calls and outbound outreach for risk-bearing providers, payers, and enablers serving Medicare and Medicaid populations. Clara's work includes annual wellness visit outreach, screenings, post-discharge care management, scheduling, and escalation to care teams. We run Clara as a managed service, which means we own the ongoing work of keeping it clinically sound, well integrated, and effective as programs scale.

About the Role

We are hiring a Head of Care Management to be the clinical lead for Clara's care management efforts. You will make sure every conversation Clara has follows sound clinical protocols and care management best practices, oversee quality across all live programs, and make the clinical and operational calls that shape how Clara works with patients. You will work closely with our founders, product and engineering team, and the clinical leaders at our customer organizations. This role reports to the CoCEO.

What You'll Do

Clinical design and protocols

• Translate clinical protocols and care management workflows (transitional care, discharge follow-up, chronic and complex care management) into Clara's conversation design

• Define triage logic and escalation criteria, including when and how Clara hands a patient to a clinician and how urgent and routine clinical escalations are handled

• Review and approve scripts, assessments, and patient-facing language for clinical accuracy, clarity, and appropriateness across populations

• Adapt Clara to each customer's clinical protocols while keeping our baseline standards consistent

Quality and patient safety

• Build and run Clara's clinical quality program, including call review, audit sampling, and scoring standards

• Define and track clinical quality metrics and report on them internally and to customers

• Investigate and resolve clinical incidents and edge cases, and turn findings into protocol or product changes

• Confirm that documentation Clara returns to customer systems accurately reflects what patients reported, supporting care management, quality, and risk adjustment programs

Clinical and operational decision-making

• Serve as the final clinical sign-off before any new use case or workflow goes live

• Make day-to-day clinical and administrative decisions on live programs, including escalation handling, patient follow-up rules, and outreach cadence

• Partner with product and engineering to prioritize clinical improvements on the roadmap

• Help set policies related to clinical scope, privacy, and patient communication requirements in coordination with legal and compliance

Customer partnership

• Act as the clinical counterpart to customer care management, quality, and nursing leaders during implementation and ongoing program reviews

• Bring clinical credibility to sales conversations and help prospects understand how Clara fits into their care model

What You Bring

• Active, unrestricted RN license

• 7+ years of clinical nursing experience, including 5+ years in care management

• Hands-on experience with transitional care, chronic care management, or complex care management programs

• Working knowledge of quality programs (HEDIS, Stars) and CMS care management program requirements

• Experience building or improving care management protocols, workflows, or quality programs

• Comfort working with technology teams and interest in how AI can extend what care teams can do

• Clear written and verbal communication with clinicians, executives, and engineers

Nice to Have

• BSN required, MSN a plus

• Certified Case Manager (CCM) credential

• Telephonic or remote care management experience