Remote Clinical Operations Nurse – 256033 (LPN/LVN, RN)

Job Title: Clinical Operations Nurse

Location: Remote

Ideal Candidate Background: LPN or RN with Prior Authorization experience is a major plus. Telehealth or start up experience is also a big plus.

Pay: Negotiable DOE/location, $48-55/hr+ (ask about pay if an NP)

Responsibilities:

• Perform clinical care coordination activities, including patient outreach, care management support, and follow-up related to chronic disease management and preventive care initiatives.
• Review complex clinical and administrative cases requiring licensed clinical judgment, including utilization review, prior authorization support, appeals, and documentation validation.
• Monitor quality and compliance by conducting routine audits, identifying process improvement opportunities, and supporting corrective action initiatives.
• Develop and maintain clinical guidelines, workflow documentation, educational materials, and standard operating procedures.
• Train and mentor clinical team members on workflows, quality expectations, and operational best practices.
• Collaborate with operational, product, and technology teams to improve clinical workflows, evaluate new processes, and provide subject matter expertise on healthcare operations.
• Participate in workflow testing, process optimization, and implementation of new operational initiatives.
• Assist with special projects that improve scalability, efficiency, and overall clinical performance.

Required Skills:

• Active Registered Nurse (RN), Licensed Practical Nurse (LPN) or Nurse Practitioner (NP).
• Bachelor’s degree in Nursing required for RNs; Master’s degree required for Nurse Practitioners.
• 2–5 years of clinical experience, including direct patient care and/or care management, utilization management, population health, case management, or similar healthcare operations.

Preferred Skills:

• Experience supporting healthcare technology, digital health, managed care, health systems, or other technology-enabled healthcare environments is preferred.
• Strong analytical and critical thinking skills with the ability to make sound clinical decisions.
• Experience reviewing clinical documentation, quality metrics, and operational workflows.
• Excellent communication and collaboration skills with the ability to work across multidisciplinary teams.
• Highly organized with strong attention to detail and a continuous improvement mindset.
• Ability to thrive in a dynamic, fast-paced environment with evolving priorities.

Schedule/Shift: M-F, 9-6 EST