Sr. Director, Care Continuum Operations

The Why Behind Wellvana:

The healthcare system isn’t designed for health. We’re designed to change that. We’re Wellvana, and we help doctors deliver life-changing healthcare.

Through our elevated value-based care programs, we’re revitalizing an antiquated system that’s far too long relied on misaligned incentives that reward quantity of care not the quality of it.

Our enlightened approach—covering everything from care coordination to clinical documentation education to marketing— ties the healthy outcomes of patients directly to shared savings for primary care providers, health systems and payors.

Providers in our curated network keep their independence, reduce their administrative headaches, and spend more time with patients. Patients, in turn, get an elevated experience with coordinated care between appointments that is nothing short of life-changing.

Named 2024 "Best in Business" and 2023 "Best Place to Work" by Nashville Business Journal, we’re one of the fastest-growing healthcare companies in America because what we do works. This is the way medicine is meant to be.

Clarity of the Role:

The Sr. Director, Care Continuum Operations is accountable for the design, operational execution, and performance of Wellvana's Care Management and Site of Care service lines across the value-based care network. This leader owns Longitudinal Care Management (LCM) and Discharge Care Management (DCM) under both full-service and advisory delivery models, as well as the Site of Care function, which encompasses post-acute network performance and health system advisory support for discharge planning. In close partnership with executive leadership, clinical leadership, analytics, and partner-facing teams, the Sr. Director translates enterprise priorities into scalable operating models that improve care transitions and reduce avoidable utilization, lowering total cost of care while sustaining quality and patient experience across partners and contract types.

The Sr. Director designs and evolves the program architecture behind both service lines, including staffing and caseload methodology, care pathways, workflows, technology enablement, and performance frameworks. The Sr. Director is accountable for the enterprise measures these models exist to move, including admission rate, readmission rate, post-acute utilization, SNF length of stay, discharge-to-home rate, emergency department utilization, and patient engagement — each a direct lever on total cost of care and shared savings performance. Leading a team of functional leaders and their combined staff, the size and structure of which will evolve as the organization scales, the Sr. Director establishes a single operating cadence across Care Management and Site of Care so the two functions perform as one continuum rather than as parallel programs.

What's Expected:

Program Design and Model Evolution

• Stay ahead of evolving CMS value-based care programs and payment models, and drive innovation in program offerings that position Wellvana to capitalize on new opportunities as they emerge.
• Identify and drive adoption of AI-enabled tools and innovations across both Care Management and Site of Care, ensuring new capabilities are evaluated, piloted, and scaled in ways that improve outcomes and operational efficiency.
• Own the design and ongoing evolution of Wellvana's care continuum operating model, spanning care management and post-acute network management.
• Define the service architecture and delivery standards that distinguish full-service engagements, in which Wellvana delivers the service directly, from advisory engagements, in which partner-employed teams deliver the service with Wellvana enablement, including scope, staffing, service levels, and performance expectations for each.
• Develop and maintain staffing models, caseload methodology, and care pathways, adjusting as membership, acuity mix, and contract composition shift across the network.
• Build the business case for program expansion, new service offerings, and technology or vendor investment, presenting recommendations to executive and clinical leadership with defensible cost, capacity, and outcome assumptions.
• Partner with Product, Analytics, and Clinical leadership to define platform and data requirements, including ADT feeds, next site of care reporting, and workflow tooling, ensuring programs are operationally supportable at scale.
• Lead implementation and go-to-market readiness for new care continuum programs, including standard operating procedures, training curricula, partner-facing materials, and launch sequencing.

Care Management Operations

• Ensure care management services are delivered in compliance with evidence-based clinical protocols, contractual obligations, industry-comparable quality standards, and applicable state and program requirements.
• Govern standards for assessment, care planning, care coordination, and ongoing monitoring, and oversee the quality review process that verifies consistent application across the team.
• Monitor key performance indicators for patient engagement, caseload productivity, care plan completion, and clinical outcomes, directing course corrections when performance trends off target.
• Oversee the two-lane delivery model that pairs AI- and technology-enabled outreach for lower-risk patients with clinician-led management for high-risk populations, ensuring the AI-driven tooling, workflows, and escalation logic route patients to the appropriate lane and support clinicians with timely, relevant insights.
• Direct advisory engagements in which partner-employed care teams deliver the service, providing model design, workflow build, training, reporting, and performance coaching to partner leadership.
• Site of Care Operations
• Own post-acute performance across the network, including skilled nursing and home health utilization, length of stay, readmissions, and discharge patterns, as well as the annual network performance review and patient choice list refresh.
• Direct the health system advisory work supporting discharge planning, ensuring patients are discharged to the clinically appropriate next site of care and that avoidable institutional placement is reduced.
• Oversee use of real-time ADT notification and next site of care data to drive timely intervention at admission, transfer, and discharge.
• Establish preferred network standards, performance criteria, and engagement cadence for skilled nursing and home health partners, including joint operating reviews with the highest-volume facilities.
• Integrate Site of Care workflows at the point of transition, in anticipation of Site of Care's planned transition into Discharge Care Management, so that discharge management hands off cleanly.

Team Leadership and Performance Management

• Lead, coach, and develop the function's leaders, and their combined clinical and operational staff, fostering a culture of engaged, valued employees with a strong emphasis on continuing education and career growth.
• Own organizational structure, hiring, capacity planning, performance management, and succession planning across both functions, with deliberate attention to knowledge continuity through growth and personnel change.
• Establish a unified operating cadence across the care continuum, including performance reviews, action planning, and escalation pathways.
• Maintain enterprise dashboards and reporting frameworks and deliver performance readouts to executive leadership and partner leadership.
• Represent the care continuum function in executive forums, partner business reviews, and cross-functional planning, and review team-produced materials before they reach executive or partner audiences.
• Monitor CMS regulation and policy affecting care management, post-acute care, and value-based payment, and translate changes into operational requirements for the team.

What's Required:

• Integrity: The right way is the only way.
• Dependability: You do what you say you’re going to do.
• Advocacy: You fight for the best possible outcome for providers and their patients.
• Clarity: You make it all understandable.

Years of Related Experience:

• 10+ years of healthcare experience across care management, post-acute or transitions of care, and value-based care operations, with 6-8+ years of people leadership including experience leading through other leaders

Skills/Competencies/Behaviors:

• Demonstrated success designing and scaling clinical programs that measurably reduce readmissions, post-acute utilization, and total cost of care
• Proven experience supporting MSSP, ACO REACH, Medicare Advantage, or other risk-bearing value-based care models across multiple markets
• Experience delivering services under both direct-delivery and advisory models with external provider organizations
• Deep expertise in care management program design, including risk stratification, caseload methodology, staffing models, and care pathway development for complex and frail populations
• Comprehensive post-acute knowledge spanning skilled nursing, home health, and hospital discharge planning, and the clinical and financial drivers of site-of-care decisions
• Working fluency in ADT and interoperability workflows, care management platforms, and the technology enablement required to operate at national scale
• Advanced ability to translate claims, clinical, and utilization data into actionable operating plans and course corrections
• Proven success leading cross-functional initiatives, driving organizational change, and delivering results through strong operational execution
• Executive-level communication skills with demonstrated ability to present effectively to senior leadership, partner executives, and board-level stakeholders
• Working knowledge of industry-comparable quality accreditation standards and CMS regulatory requirements affecting care management and post-acute care