Remote Cms Developer Jobs in California (NOW HIRING)

About us
W Health Ventures has set up India's first healthcare focused Venture Studio called2070Health - an innovation platform that builds transformative healthcare companies from scratch by discovering disruptive opportunities in whitespaces. Distinct from the accelerator approach, our venture studio is closely involved in idea generation, day-to-day operations, and strategic decisions of growing the new business. Companies incubated in the last 24 months include Elevate Now, Nivaan Care, Reveal Healthtech , BabyMD and Everhope Oncology.

This role is for a company we are incubating within the studio.

About Kero Health

Kero Health is a care navigation platform that embeds directly inside physician practices to operationalize two new Medicare billing codes: Community Health Integration (CHI, G0019/G0022) and Principal Illness Navigation (PIN, G0023/G0024). We provide the staffing, technology, and compliance infrastructure so practices can generate new reimbursement revenue from care navigation without any upfront investment. Our navigators work under the practice's brand, are AI-assisted but human-centered, and every billing packet we produce is audit-ready. Backed by W Health Ventures, Leo Capital, and Sanos Capital.

The Role

You are the first operational hire - the person who has actually done this work and can now architect how it's done at scale. You've been a community health worker, patient navigator, or care coordinator yourself. You've screened for SDOH needs, helped patients navigate Medicaid, coordinated specialist referrals, logged your time under incident-to billing rules, and dealt with the messy reality of helping complex patients stay on their care plan. Now you're ready to take that lived expertise and build the entire care navigation operation from zero: the workflows, the training curricula, the QA systems, the team.

This is not a strategy-only role. In the early months you will personally carry a caseload of patients alongside our first practice partners to validate our workflows, stress-test our platform, and write the playbook that every future navigator will follow.

Location: Remote (US-based) | Willingness to travel to practice partner sites

What You'll Own

Build the operation from scratch. Design end-to-end navigator workflows for both CHI (SDOH barrier resolution) and PIN (serious chronic illness navigation) - from patient identification and enrollment through monthly time documentation and billing attestation. Establish the 16-phase workflow across identification, consent, initiating visit coordination, navigator assignment, disease-specific navigation, specialist coordination, medication management, care transitions, insurance/financial navigation, caregiver support, time tracking, billing review, claims, workforce ops, offboarding, and outcomes reporting.

Carry a patient caseload initially. Work directly with the first practice partners to navigate real patients - conduct SDOH screenings, coordinate referrals, log billable time, and generate the documentation artifacts that prove the model works. Target: 15-25 patients/month at 60+ documented minutes each.

Hire and train the navigator team. Define the navigator profile (CHW certification, condition-specific training, language capabilities). Build training programs covering CMS's 8 billable service categories: person-centered assessment, care coordination, health education, self-advocacy coaching, healthcare system navigation, behavioral change facilitation, social/emotional support, and leveraging condition knowledge. Develop condition-specific modules for oncology, CHF, COPD, dementia, CKD, HIV/AIDS, SMI, SUD, and other qualifying conditions.

Own compliance and audit readiness. Ensure every navigator interaction meets CMS documentation standards - proper consent collection, initiating visit linkage, time-based billing thresholds (60-min base, 30-min add-ons), non-duplication with CCM/RPM, general supervision documentation, and ICD-10/Z-code accuracy. Build the QA cadence: case conferences, chart audits, caseload reviews.

Shape the product. Work hand-in-hand with the engineering team to define what navigators need from the Kero platform - time logging interfaces, care plan templates, SDOH screening tools, escalation workflows, attestation dashboards. You are the voice of the navigator in every product decision.

Scale the model. Document everything into repeatable playbooks. Define caseload ratios, hiring rubrics, onboarding timelines, and performance metrics. Build the operating model that lets Kero go from 1 practice to 50.

Requirements

You Should Have

• 5+ years of direct, hands-on experience in community health work, patient navigation, or care coordination - you have personally carried a patient caseload
• At least 2 years in a supervisory or program management role overseeing CHWs, patient navigators, or care coordinators
• Deep working knowledge of Medicare billing, specifically incident-to services, and ideally direct experience with CHI (G0019/G0022) or PIN (G0023/G0024) codes
• Fluency in SDOH screening tools (AHC HRSN, PRAPARE, or similar) and community resource navigation
• Experience building programs or teams from scratch - not just inheriting and maintaining
• Understanding of CMS compliance requirements: time-based billing, documentation standards, audit preparation
• CHW certification, patient navigator certification, or equivalent clinical/social work credential

Strongly Preferred

• Experience navigating patients with serious chronic conditions (oncology, CHF, CKD, COPD, dementia)
• Familiarity with FQHC, health system, or managed care organization care navigation programs
• Experience working with or building health technology platforms (EHR workflows, care management systems)
• Bilingual (Spanish/English strongly preferred given patient demographics)
• Comfort operating in an early-stage, ambiguous environment where you're writing the rules, not following them