Lead RN, Utilization Management
Clover Health · Remote - USA · Remote-friendly
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- Company
- Clover Health
- Location
- Remote - USA
- Salary
- $100,000 — $130,000
- Posted
- October 20, 2026
About this job
The Utilization Management (UM) team plays a vital role in supporting Clover members throughout their care journey. The team is made up of experienced clinicians who combine clinical expertise with data-driven insights to support evidence-based decision-making. Working closely with providers and care partners, the UM team ensures that care transitions are smooth, efficient, and always focused on improving member outcomes while maintaining compliance with CMS guidelines. As the Lead RN, Utilization Management, you will coach and develop clinical staff, oversee daily review operations, and monitor quality and vendor performance. You will partner with Medical Directors and teams across Clover to strengthen review consistency and improve workflows.…
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