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Lead RN, Concurrent Review, Remote Anywhere

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Opportunity Overview: Cohere’s Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in Service Operations position is a crucial role in our organization. In this role, you are responsible for coaching, mentoring, evaluating and developing the RN team. The Lead RN Reviewer will use established operational tools to ensure all RN staff are meeting or exceeding performance metrics and quality standards established by the leadership team. As a Lead RN Reviewer, you will work closely with the leadership team and report to the Clinical Supervisor of Service Operations.  You will be responsible for providing supervision for the RN Reviewers 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.  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. What you’ll do:

  • Gain a deep understanding of Cohere’s product and our health plan partners
  • Provide general supervision over the nursing staff. This includes interviewing new hires, training, coaching, mentoring, quality auditing and oversight of quality improvement plans initiated by the Clinical Supervisor and or Director.
  • Coordinates and provides day-to-day oversight and direction to clinicians
  • Assist in addressing any case escalations or provider issues
  • Other duties as assigned
What you’ll need:
  • 5+ years experience in Managed Care, Healthcare or Health Insurance related field
  • 1-2 years previous Supervisory or Lead experience
  • Current RN Licensure required, Bachelor’s degree in related field preferred
  • Able to develop and train large groups and/or one on one
  • Skilled in understanding others’ perspectives and challenges
  • Able to interpret operational reports and drive process improvement initiatives
  • Be kind and patient while demonstrating subject matter expertise
  • Excellent interpersonal skills, oral and written communication skills
  • Able to break down big challenges into organized plans
  • Intellectually curious with a strong desire to understand and constantly improve your work and business processes
  • Able to work cross functionally across remote teams
  • Flexible and agile in ambiguous situations; open to changes in role and scope as the business grows
  Pay & Perks: 💻 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 The salary range for this position is $35 to $37 per hour; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.   Interview Process*:
  1. Connect with Talent Acquisition for a Preliminary Phone Screening
  2. Meet your Hiring Manager and Behavioral Interview(s)
*Subject to change   About Cohere Health: Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members. With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone. We can’t wait to learn more about you and meet you at Cohere Health! Equal Opportunity Statement:  Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all.  To us, it’s personal.
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2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

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10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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