Lead RN Reviewer

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 in healthcare, managed care, or insurance-related roles 1–2 years in a lead or supervisory capacity, with experience coaching or training others A current, active RN license (BSN preferred) Utilization Management experience required Comfort interpreting operational data and metrics to identify process improvements Excellent communication, collaboration, and organizational skills A kind, patient, and flexible leadership style suited for a remote, fast-paced environment 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 hourly; 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*: Connect with Talent Acquisition for a Preliminary Phone Screening Internet Speed Test Take Home Assignment Meet your Hiring Manager! *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 Hea…