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About the Role

Everlywell is a digital health company focused on providing personalized health answers through AI-powered technology and human insight. This role supports clinical programs in a virtual setting, overseeing daily operations, ensuring quality assurance, and managing clinical teams.

Responsibilities

• Provide functional leadership to internal and contractor/vendor assigned RNs and MAs, RN/MA program leads, and RN/MA supervisors.
• Ensure coverage is distributed to prevent single-point strain and minimize program risks.
• Ensure RN/MA documentation meets HEDIS/CMS, client, and internal SOP standards.
• Maintain HIPAA, privacy, and policy adherence across internal and contractor/vendor staff.
• Maintain a living RACI for programs.
• Ensure invoice/billing for RN/MA groups monthly.
• Provide required clinical input on IVR dialer management.
• Monitor and report on clinical KPIs and trigger corrective actions.
• Partner with Analytics to produce weekly/monthly clinical metrics reports and ad-hoc deep dives.
• Present operational summaries and clinical insights to leadership and clients as requested.
• Own the quality assurance program for assigned clinical programs, including design, execution, and continuous improvement.
• Own and run the chart-audit program to ensure processes are performed per quality standards.
• Execute AI-enabled chart audit processes per client allowance.
• Complete chart audits reviewing process and health outcomes related to program goals.
• Perform retrospective chart reviews of RN/MA (and provider, as applicable) consults, documentation, and care notes.
• Evaluate documentation for clinical accuracy, completeness, professionalism, and adherence to internal protocols and external standards.
• Identify patterns in documentation deficiencies or clinical deviations and translate them into targeted training or system improvements.
• Design and maintain sampling plans, run audit tools, and coach to closure with RN/MA teams.
• Own quality initiatives and feedback loops for continuous improvement.
• Coordinate RN/MA activities to ensure high-quality completion of visit intake, referral and order follow-up, result interpretation, genetic test order reviews, and routine chart audits.
• Ensure RN/MA coverage for required post-consult follow-up and close the loop on outstanding actions.
• Deliver onboarding, orientation, and skills training for new clinical team members.
• Create and update training resources, and maintain program quick-refs, scripts, and FAQs.
• Coordinate annual refreshes with Clinical Solutions Coordinator.
• Conduct periodic refresher trainings or workshops based on emerging trends or observed gaps.
• Assist with RN/MA and provider questions regarding workflows, documentation, or standards of care.
• Collaborate with operations, compliance, and clinical leadership to ensure training materials are aligned with current practice and regulatory expectations.
• Validate competency via structured knowledge checks and skills assessments.
• Partner with staffing agency/vendor leadership for contract RN/MA recruitment, quality, staffing, attendance, onboarding and offboarding.
• Align roles/responsibilities and escalation paths with supervisors.
• Ensure training cohorts support rapid and high volume staffing needs.
• Direct and support RN/MA–led outreach to ensure protocol adherence.
• Address patient questions about health status, results, treatment plans, and medications as appropriate.
• Escalate to provider per protocol.
• Deliver lab results and provide result information per script or protocol.
• Apply standardized triage protocols, urgent and emergent protocols and clinical judgment to prioritize needs.
• Refer patients to the appropriate level of care (ED, PCP, specialists) as indicated.
• Document triage assessments, education, and decisions accurately and comprehensively.
• Own the creation and maintenance of RN/MA care-coordination and patient education protocols.

Requirements

• Bachelor's Degree in Nursing or similar field from an accredited college or university; or equivalent professional experience.
• Licensed Registered Nurse (RN); compact or multistate licensure preferred.
• 5+ years of professional clinical, nursing, or related experience; virtual/telehealth experience preferred.
• Two years or more leading clinical teams or large cohorts in high-volume settings; vendor-partner management experience is a plus.
• Demonstrated experience owning clinical quality assurance, chart-audit, and/or documentation-review programs.
• Demonstrated skill in program operations, workforce coordination and KPI-driven management.
• Understanding of broader clinical environment and alternative venues for care like telehealth.
• Understanding of HIPAA regulations, privacy policies, and external quality standards (e.g., CMS, HEDIS).
• Familiarity with clinical documentation standards, quality improvement principles, and adult learning methods.
• Working knowledge of risk adjustment documentation requirements—including HCC coding principles and MEAT criteria—is a plus.
• Experience using diverse technologies, such as: Athena, Healthie, Salesforce, Zendesk, Twilio, Slack, & Google Docs.
• Proficiency in Microsoft Office or equivalent applications required.
• Ability to create/execute training plans and conduct targeted QA with coaching.
• Able and willing to learn/adjust to changes in protocols and/or workflows.
• Ability to manage multiple priorities and respond in a timely manner.
• Ability to execute under accelerated timeframes and quickly adapt to changes in priorities.
• Excellent interpersonal skills, enabling effective communication with clinicians, colleagues and staff.
• Excellent written and telephonic communication skills.
• Skilled in developing, implementing, and administering work processes.
• Strong organizational and time management skills; strong attention to detail.

Skills

• Clinical Program Management
• Quality Assurance
• Chart Auditing
• Documentation Review
• Clinical Operations
• Team Leadership
• Virtual/Telehealth Care
• HIPAA Compliance
• HEDIS/CMS Standards
• Training and Development
• Patient Education
• Care Coordination
• Risk Adjustment Documentation
• HCC Coding Principles
• MEAT Criteria
• Athena
• Healthie
• Salesforce
• Zendesk
• Twilio
• Slack
• Google Docs
• Microsoft Office
• Interpersonal Communication
• Written Communication
• Telephonic Communication
• Process Development
• Organizational Skills
• Time Management
• Attention to Detail

Location

• Virtual

Work Type

• Full-time

Experience Level

• 5+ years clinical/nursing experience
• 2+ years team leadership experience

Education Level

• Bachelor's Degree in Nursing or equivalent professional experience
• Licensed Registered Nurse (RN)

About the Company

• Everlywell is a digital health company pioneering the next generation of biomarker intelligence—combining AI-powered technology with human insight to deliver personalized, actionable health answers.
• We transform complex biomarker data into life-changing insights—seamlessly integrating advanced diagnostics, virtual care, and patient engagement to reshape how and where health happens.
• Over the past decade, Everlywell has delivered close to 1 billion personalized health insights, transforming care for 60 million people and powering hundreds of enterprise partners.
• In 2025, an estimated 1 in 94 U.S. adults received an Everlywell test, solidifying our spot as the #1 at-home testing company in the country.
• Fueled by AI and built for scale, we’re breaking down barriers, closing care gaps, and unlocking a more connected healthcare experience that is smarter, faster, and more personalized.