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Cohere Health

RN Supervisor, Clinical Operations

RemoteUnited States only
Published
Role
Operations
Experience
Senior
Employment
Full-time
Company size
Startup
$85k–$95k/yr
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Open to US only. Set where you work from to check your eligibility.

No BS summary

Supervises RN Reviewer team, ensuring performance metrics and quality standards are met. Requires an RN license, 2-3 years of supervisory experience, knowledge of NCQA/CMS requirements, and experience with clinical criteria guidelines and utilization management. Must be comfortable supervising in a remote environment.

Required skills

MCGCMS NCDsclinical criteria guidelines

What you'll do

  • Oversee the RN Reviewer team including one RN Team Lead
  • Establish a plan for the day and communicate to all staff daily
  • Manage the daily timeliness report and ensure all cases meet expected turnaround times
  • Monitor the nurse productivity reports daily and provide feedback to the nurses, managing performance to ensure consistency
  • Lead weekly team meetings
  • Capture process efficiency ideas from the team and work with the appropriate stakeholders to recommend and lead changes needed to improve nurse efficiency.
  • Meet individually with all direct reports on bi-weekly cadence to develop solid work relationships with each team member and to share any performance feedback, positive and constructive.
  • Working with the RN Reviewer Leads, track hourly nurse productivity, keeping the Director/Manager informed on productivity results as needed.
  • Train and Develop new RNs who join the team.
  • Oversee daily newsletter publication
  • May be asked to help with other projects as needed.

What they require

  • Registered Nurse with an active and unencumbered license to practice
  • 2-3 years of supervisory/management experience
  • Knowledge of NCQA/CMS requirements
  • Prior Authorization or Utilization Management experience
  • Excellent computer skills and familiarity with a Mac.
  • Experience supervising and training in a remote work environment.

Benefits

  • Medical, dental, vision, life, disability insurance, and Employee Assistance Program
  • 401K retirement plan with company match; flexible spending and health savings account
  • Up to 184 hours (23 days) of PTO per year + company holidays
  • Up to 14 weeks of paid parental leave
  • Pet insurance

Cohere Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care.

HealthcareStartup
$85k–$95k/yr