RN Reviewer at Cohere Health

Cohere Health is hiring an RN Reviewer to perform prospective, concurrent, and retrospective utilization reviews to determine medical necessity and appropriateness of care across Commercial, Medicare, and Medicaid lines of business. The role partners with Medical Directors and cross-functional teams to support quality, accreditation, and regulatory initiatives, and requires an active RN license, 3+ years of clinical experience, utilization management experience, and familiarity with NCQA/CMS standards and MCG guidelines. This is a full-time, 100% remote position with weekend shift availability, about 5% travel, and compensation of $33 to $35 per hour plus benefits.