Manager, Clinical Operations
About The Position
Cohere’s Clinical Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Manager, Clinical Operations position is a crucial role in our organization. In this role, you are responsible for coaching, mentoring, evaluating and developing the Reviewer team leadership and front line staff. The Manager will use established operational tools to ensure all Nurse staff and leaders are meeting or exceeding performance metrics and quality standards established by the leadership team. As a Manager, you will work closely with the leadership team at Cohere and report to the Sr. Director/Director, Clinical Operations. You will be responsible for providing daily operational guidance to the leadership and Nurse Reviewers to allow them to meet or exceed operational objectives and metrics. You will leverage both your creative skills and communication skills to promote a high performing clinical team. The Manager, Clinical Operations will be highly organized in order to plan daily operational activities and provide oversight of the Nurse Review teams. You will be responsible to work with the Sr. Director and leadership to develop the team’s future strategy to meet the organization’s goals. You will use your professionalism, personality, and communication skills to inspire the team to meet or exceed all performance standards. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities.
Requirements
- Registered Nurse with an active and unencumbered license to practice
- 5+ years of supervisory/management experience
- Knowledge of NCQA/CMS requirements
- Experience using MCG, CMS NCDs/LCDs
- 3+ years Prior Authorization, Utilization Management and/or Appeals experience required
- Excellent computer skills and familiarity with a Mac.
- Experience supervising and training in a remote work environment
Responsibilities
- Oversee the Prior Auth Nurse Reviewers, Concurrent Review Nurses, or Appeals Specialists teams
- Mentor and develop team members in partnership with leadership
- Set daily team priorities and communicate expectations to staff
- Monitor timeliness reports to ensure cases meet turnaround time expectations
- Review nurse productivity metrics and provide ongoing performance feedback
- Lead weekly team meetings and biweekly 1:1s with direct reports
- Identify process improvement opportunities and collaborate with stakeholders to enhance efficiency
- Support recruiting, interviewing, onboarding, and training of new employees
- Maintain strong cross-functional relationships and provide leadership coverage as needed
- Track nurse productivity and update the Director on performance trends
- Advise leadership on process and system improvement opportunities
- Demonstrate and promote the core values of Cohere Health
- Support additional projects as needed
Benefits
- Fully remote opportunity with about 5% travel
- 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
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
