Director of Care Management & Member Navigation

TRIARQ Health is a trusted partner to independent medical practices, enabling their independence and success in a value-driven healthcare ecosystem. We align with payers and enable practices with advanced technology, actionable insights, and tailored support that reduce administrative burdens, simplify operations, and drive sustainable growth—making specialists more attractive to members and referring providers.

We improve outcomes and affordability by proactively guiding members into evidence-based, conservative care pathways, ensuring they connect with high-value providers, avoiding unnecessary procedures, and enabling a coordinated care journey that balances quality, cost, and patient satisfaction.

Role Overview

The Director of Care Management & Member Navigation leads TRIARQ's specialty care management programs, balancing strategic leadership with hands-on execution. This role oversees the design, implementation, and continuous improvement of care navigation, outreach, and engagement initiatives that guide members across their care journey—from diagnosis through recovery.

The Director will manage teams of therapists, nurses, care coordinators, and navigators, while also driving campaign execution, provider alignment, and payer reporting. A central responsibility is to implement multimodal engagement strategies, including one-to-many outreach tools, to improve patient adherence, provider compliance, and affordability outcomes.

Key Responsibilities

Program Design & Leadership

• Build and scale care management programs across MSK, Urology, and other high-value specialties.
• Develop standardized care pathways and plans with physician input; integrate payer medical policy into workflows to streamline utilization management and prior authorization.
• Translate affordability and quality objectives into actionable interventions for care teams.
• Collaborate with Member Experience, Program Management, and Provider Engagement teams to align strategies and priorities, ensuring care management programs are seamlessly integrated into operations and provider partnerships.

Operational Oversight & Execution

Care Management and Navigation

Provider Integration

Analytics & Reporting

Qualifications

Why Join TRIARQ?

At TRIARQ, you will help transform specialty care by making healthcare more affordable, member-centered, and provider-aligned. Specialty utilization and spend represent nearly 50% of total healthcare costs, and we are focused on building a new care delivery model that aligns payers and providers to create better outcomes. This role is a unique opportunity to shape the future of healthcare while also rolling up your sleeves to execute—ensuring members feel supported, providers stay engaged, and payers achieve measurable affordability gains.

You'll be at the center of TRIARQ's mission : guiding members through complex care journeys, enabling specialists to succeed, and proving that affordability and quality can go hand in hand.