Background: E-learning as a new learning method influences process of transforming conventional education into a digital basis. Massive Open Online Course (MOOC) is used as an e-learning management system that disseminates nursing institution partners' knowledge. An E-learning system provides highly configurable and integrated features in electronic books, journals, and web services. This system quickly, effectively, and economically distributes educational content toward students without any time or learning space limitation. Elearning has been implemented in various learning subjects, including nursing, but remains limited in clinical rotation nursing education. It has not been implemented widely, even though it is proven to support the learning process. Aim: The study aims to describe the process of developing an E-learning system in clinical rotation nursing education. Methods: The course subject was nursing management by involving two education institution partners. School of Nursing, Faculty of Medicine, Public Health, and Nursing (FKKMK) UniversitasGadjahMada (UGM) designed clinical learning innovation for clinical rotation nursing students in blended learning. It involved the institution's partner students as the learning participants. Results: The process of developing E-learning in the clinical rotation nursing was by building partnership with education institutions passed through several phases: curriculum development, instructional design, and teaching media development, program evaluation methods, utilization of Learning Management System (LMS) as well as student learning outcomes evaluation. System design and development followed student needs resulting in the high score of participants' learning outcomes in clinical rotation nursing education. Conclusion: Appropriate E-learning system development strategy benefits student learning processes during nursing management practice in clinical rotation nursing education program.