Clinical Program and Quality Manager

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.

What You'll Do

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Clinical RN/MA Program & Team Operations Oversight

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Partner with Network Ops on capacity planning and scheduling.

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Own daily clinical operations for assigned RN/MA programs (e.g., BP), including supervisory activities, team huddles, daily performance review, coverage plans, and service recovery.

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Provide functional leadership to internal and contractor/vendor assigned RNs and MAs, RN/MA program leads, and RN/MA supervisors

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Expectations, performance, oversight and supervisory delegations.

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Ensure coverage is distributed to prevent single‑point strain and minimize program risks.

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Ensure RN/MA documentation meets HEDIS/CMS, client, and internal SOP standards.

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Maintain HIPAA, privacy, and policy adherence across internal and contractor/vendor staff.

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Maintain a living RACI for programs.

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Ensure invoice/billing for RN/MA groups monthly.

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Clinical Program RN/MA Monitoring and Reporting

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Provide required clinical input on IVR dialer management.

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Monitor and report on clinical KPIs (staffing levels, real-time performance metrics, capacity constraints, engagement, completion, escalations, documentation, and safety events, or other operational metrics) and trigger corrective actions.

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Partner with Analytics to produce weekly/monthly clinical metrics reports and ad‑hoc deep dives that support internal and client reporting and renewals.

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Present operational summaries and clinical insights to leadership and clients as requested.

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Clinical Quality Assurance, Chart Audit & Documentation Review

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Own the quality assurance program for assigned clinical programs, including the design, execution, and continuous improvement of quality monitoring and improvement activities.

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Own and run the chart-audit program to ensure chart-audit processes are performed per quality standards.

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Execute AI-enabled chart audit processes per client allowance.

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Complete chart audits reviewing process and health outcomes related to program goals.

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Perform retrospective chart reviews of RN/MA (and provider, as applicable) consults, documentation, and care notes.

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Evaluate documentation for clinical accuracy, completeness, professionalism, and adherence to internal protocols and external standards (e.g., CMS, HEDIS, HIPAA).

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Identify patterns in documentation deficiencies or clinical deviations and translate them into targeted training or system improvements.

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Design and maintain sampling plans, run audit tools, and coach to closure with RN/MA teams.

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Own quality initiatives and feedback loops for continuous improvement, closing the loop between audit findings, education, and program performance.

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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.

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Ensure RN/MA coverage for required post-consult follow-up and close the loop on outstanding actions.

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Clinical Education & Training

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• Deliver onboarding, orientation, and skills training for new clinical team members across multiple roles (RNs, MAs, and other clinical staff).
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• Create and update training resources (e.g., presentations, SOPs, job aids), and maintain program quick-refs, scripts, and FAQs for internal use.
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• Coordinate annual refreshes with Clinical Solutions Coordinator.
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• Conduct periodic refresher trainings or workshops based on emerging trends or observed gaps, informed by chart-audit and QA findings.
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• Assist with RN/MA and provider questions regarding workflows, documentation, or standards of care.
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• Collaborate with operations, compliance, and clinical leadership to ensure training materials are aligned with current practice and regulatory expectations.
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• Validate competency via structured knowledge checks and skills assessments.
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RN/MA Recruitment, Onboarding, and Training

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• Partner with staffing agency/vendor leadership for contract RN/MA recruitment, quality, staffing, attendance, onboarding and offboarding.
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• Align roles/responsibilities and escalation paths with supervisors.
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• Ensure training cohorts support rapid and high volume staffing needs.
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Patient Education & Care Coordination

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Direct and support RN/MA–led outreach to ensure protocol adherence, including

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• Addressing patient questions about health status, results, treatment plans, and medications as appropriate (phone/virtual).
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• Escalating to provider per protocol
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• Delivering lab results and providing result information per script or protocol.
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• Applying standardized triage protocols, urgent and emergent protocols and clinical judgment to prioritize needs.
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• Referring patients to the appropriate level of care (ED, PCP, specialists) as indicated.
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• Documenting triage assessments, education, and decisions accurately and comprehensively.
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• Own the creation and maintenance of RN/MA care-coordination and patient education protocols.

Who You Are

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• Bachelor's Degree in Nursing or similar field from an accredited college or university; or equivalent professional experience
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• Licensed Registered Nurse (RN); compact or multistate licensure preferred
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• 5+ years of professional clinical, nursing, or related experience; virtual/telehealth experience preferred
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• Two years or more leading clinical teams or large cohorts in high-volume settings; vendor-partner management experience is a plus
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• Demonstrated experience owning clinical quality assurance, chart-audit, and/or documentation-review programs
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• Demonstrated skill in program operations, workforce coordination and KPI-driven management.

Skills & Abilities Required

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Understanding of broader clinical environment and alternative venues for care like telehealth

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Understanding of HIPAA regulations, privacy policies, and external quality standards (e.g., CMS, HEDIS)

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Familiarity with clinical documentation standards, quality improvement principles, and adult learning methods

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Working knowledge of risk adjustment documentation requirements—including HCC coding principles and MEAT criteria—is a plus

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Experience using diverse technologies, such as: Athena, Healthie, Salesforce, Zendesk, Twilio, Slack, & Google Docs. Proficiency in Microsoft Office or equivalent applications required

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Ability to create/execute training plans and conduct targeted QA with coaching

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Able and willing to learn/adjust to changes in protocols and/or workflows

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Ability to manage multiple priorities and respond in a timely manner

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Ability to execute under accelerated timeframes and quickly adapt to changes in priorities

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Excellent interpersonal skills, enabling effective communication with clinicians, colleagues and staff

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Excellent written and telephonic communication skills

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Skilled in developing, implementing, and administering work processes

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Strong organizational and time management skills; strong attention to detail.