Program Manager, Registered Nurse

About Shearwater Health:

At Shearwater Health, we know that better patient outcomes are never achieved alone – especially when there aren’t enough hands to deliver care. That’s why we’ve built something different: a global team of clinicians helping solve one of healthcare’s most urgent challenges – the nursing shortage. By expanding the reach of care teams and reinforcing critical support systems, we bring clarity, compassion, and clinical expertise to the front lines of care.

As the founder of the nation’s first Clinical Process Outsourcing (CPO®) model and a Great Place to Work®-certified company, we help the world’s top healthcare organizations work smarter – scaling their teams, strengthening care, and solving real problems every day. From clinical decision support to administrative tasks, our team of nearly 6,000 clinicians and process experts work across borders and time zones to help our partners focus on what matters most: delivering exceptional patient care.

If you’re ready for your work to not just support care – but strengthen the system – join us. This is where clinicians become changemakers, and where nurses go further than they ever thought possible.

Position Overview

Shearwater Health is seeking an experienced RN Program Manager to lead the clinical and operational delivery of the Client's Utilization Management program.

This is a hands-on leadership role for an RN who understands utilization management and can translate client requirements into reliable day-to-day operations. The Program Manager will provide leadership to the clinical delivery team, coordinate staffing and readiness, monitor operational and quality performance, resolve issues, and serve as a key clinical and operational liaison with Client.

This is not a traditional project management position. The Program Manager is an operations leader accountable for the successful delivery of the program.

In the Program Manager, RN role, you will be responsible for:

Leading the Operation

• Provide day-to-day clinical and operational leadership for the Client program.
• Lead the clinical delivery team and establish clear accountability for performance.
• Monitor staffing, capacity, workload, productivity, service delivery, and operational risks.
• Ensure appropriate leadership coverage and clinical escalation pathways.
• Identify barriers to performance and drive timely resolution.

Serving as a Trusted Client Partner

• Serve as a key operational and clinical liaison between Client and Shearwater Health.
• Coordinate Shearwater resources supporting the program.
• Lead discussions involving operations, staffing, readiness, clinical workflows, quality, and service performance.
• Facilitate timely information exchange between Client and internal teams.
• Own operational issue escalation and follow-through.

Providing Clinical Leadership

• Provide RN leadership and clinical guidance to the utilization management operation.
• Support clinical decision-making and appropriate escalation when cases require additional clinical review.
• Reinforce consistent application of client policies, clinical criteria, documentation requirements, and escalation procedures.
• Partner effectively with medical directors and other designated clinical resources.
• Maintain the clinical credibility necessary to support and lead an RN-based operation.

Developing the Team

• Provide leadership and direction to Team Leads and clinical staff.
• Partner with Workforce Management and Clinical Operations on staffing and capacity planning.
• Support hiring, onboarding, retention, and development of team members.
• Partner with Training and Quality to ensure new clinicians are ready before independent production.
• Identify performance opportunities and support coaching and remediation.

Driving Quality and Improvement

• Partner with Quality, Training, Clinical Operations, and client stakeholders to maintain strong clinical quality.
• Monitor quality and performance trends and ensure identified issues are addressed.
• Support audits, remediation, and performance-improvement activities.
• Identify opportunities to simplify workflows, improve efficiency, and strengthen operational controls.
• Promote a culture of accountability, clinical integrity, and continuous improvement.

Qualification Requirements:

• Current, active, unrestricted Registered Nurse license in the United States.
• Ability to obtain and maintain an active Michigan RN license.
• Clinical RN experience with sufficient depth to provide credible leadership to an RN utilization management team.
• Utilization management, utilization review, managed care, payer, or similar clinical operations experience.
• Demonstrated people or clinical-operations leadership experience.
• Strong clinical judgment, critical thinking, and problem-solving skills.
• Ability to translate client requirements into clear operational expectations.
• Strong written, verbal, and client-facing communication skills.
• Ability to lead through change, ambiguity, and competing priorities.

Preferred Qualifications

• Current Michigan RN license.
• Hands-on experience using InterQual clinical criteria in utilization management or utilization review.
• MCG or comparable evidence-based clinical criteria experience.
• Health plan or managed-care experience.
• Leadership experience within utilization management or utilization review operations.
• Experience with prospective/prior-authorization, concurrent, and retrospective review.
• Client-facing healthcare operations experience.
• Bachelor of Science in Nursing (BSN).

Employee Benefits:

• A competitive compensation structure
• Comprehensive health insurance
• 401(k)
• Paid vacation time
• The opportunity to build your career in a rewarding and unforgettable way