Clinical Operations RN
Pluto Health
Who we are:
Pluto Health is on a mission to connect people with the care they need when they need it. Pluto bridges AI and health services, unifying health information from siloed sources and identifying the best next steps for patients in minutes. Our team creates personalized plans and collaborates to address health needs alongside our enterprise partners. Whether it involves preventive health care, at-home tests, or access to lifesaving clinical studies, we aim to provide the necessary resources to patients at the time of need through our trusted network of partners, including retail pharmacies, payers, and clinicians.
About the role:
NOTE: This role is a Durham, NC based role. Candidates will be expected to be in our Durham, NC office 2.5 days per week.
We are seeking a skilled and motivated Registered Nurse (RN) to join our team in a hybrid role that combines both clinical and clinical-administrative responsibilities. This full-time position is split approximately 50% clinical care and 50% administrative support, designed to optimize patient outcomes, support operational efficiency, and strengthen care coordination across the organization.
The ideal candidate is a detail-oriented, compassionate professional who thrives in a dynamic healthcare setting and is comfortable balancing direct patient care with behind-the-scenes responsibilities such as claims management, patient follow-up, and care coordination.
What you’ll do:
Clinical Duties (50%)
Conduct patient assessments, triage, and follow-up in alignment with clinical protocols.
Provide direct patient care via telehealth
Collaborate with providers and interdisciplinary team members to support treatment plans and care continuity.
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Document all clinical encounters accurately and timely in the electronic health record (EHR).
Administrative Duties (50%)
Manage clinical administrative workflows, including prior authorizations, claims documentation, and insurance correspondence.
Handle patient communication, including follow-up calls, test result coordination, and education on care plans.
Support quality improvement initiatives, chart audits, and compliance reporting as needed.
Assist with appointment scheduling, documentation follow-up, and internal process improvement.
Liaise with billing and care coordination teams to ensure seamless care delivery and efficient claims processing.
What you’ll need:
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Required:
Active, unrestricted Registered Nurse (RN) license.
Minimum 2–3 years of experience in a clinical setting.
Proficiency in electronic health record (EHR) systems and
Strong communication, organizational, and multitasking skills.
Ability to work independently and as part of a multidisciplinary team.
Preferred:
Experience in telehealth setting
Familiarity with medical billing, prior authorization processes, and claims management.
BLS certification (or ability to obtain upon hire).
What You Get:
Join one of the fastest-growing, venture-backed health tech companies
Work alongside a world-class team
Be part of the solution: improve the way care is delivered for millions of patients
Competitive salary and employee equity options
Comprehensive benefits including health, dental, and vision coverage
Flexible PTO policy, 10 company paid-holidays and a 4% matched 401(k)