RN Supervisor, Clinical Operations at Cohere Health

United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Registered Nurse with an active and unencumbered license to practice
2-3 years of supervisory/management experience
Knowledge of NCQA/CMS requirements
Experience using MCG, CMS NCDs/LCDs, clinical criteria guidelines
Prior Authorization or Utilization Management experience
Excellent [communication/organizational/professionalism/personality skills implied]

Responsibilities

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
Coach, mentor, evaluate, and develop the RN Reviewer team using established operational tools to ensure performance metrics and quality standards are met or exceeded
Provide daily operational guidance to RN Reviewers to meet or exceed operational objectives and metrics

Skills

Clinical Operations

Team Supervision

Performance Metrics

Quality Standards

Operational Planning

Team Mentoring

Communication

Leadership

Timeliness Management

Cohere Health

Automates prior authorization in healthcare

About Cohere Health

Cohere Health improves the prior authorization process in healthcare, which requires providers to get approval from health plans before delivering certain services. Their platform, Cohere Unify, automates and streamlines these requests by integrating with electronic medical records and using technologies like optical character recognition and machine learning. This approach allows for faster decision-making and reduces delays in patient care. The goal is to make the prior authorization process more efficient, benefiting healthcare providers, health plans, and patients.

Boston, MassachusettsHeadquarters

2019Year Founded

$103.1MTotal Funding

LATE_VCCompany Stage

AI & Machine Learning, HealthcareIndustries

501-1,000Employees

Benefits

Health Insurance

401(k) Company Match

Performance Bonus

Remote Work Options

Risks

Increased competition from AI-driven startups like Abridge threatens market share.

Flat healthcare IT deal activity may impact future funding opportunities.

Dependency on Humana partnership poses risk if challenges arise in the relationship.

Differentiation

Cohere Health automates prior authorization, reducing delays and administrative burdens.

The Cohere Unify platform integrates with EMR and uses OCR for fax submissions.

Machine learning and AI enhance decision-making based on health plan policies.

Upsides

Humana expanded Cohere's platform use, showing trust and potential for more partnerships.

Cohere raised $50 million, indicating strong investor confidence and growth potential.

KLAS award recognition highlights effectiveness, attracting more healthcare providers.

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