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Cohere Health provides a Platform-as-a-Service to streamline prior authorization in healthcare. Its Cohere Unify platform digitizes requests into a single automated workflow, integrates with electronic medical records, and uses OCR for fax submissions. It uses machine learning and responsible AI to automate decisions based on health plan policies, speeding reviews and ensuring complete information. The company licenses Cohere Unify to health plans for use by internal utilization management teams, aiming to reduce delays, cut costs, and improve patient outcomes.
Industries
Enterprise Software
AI & Machine Learning
Healthcare
Company Size
501-1,000
Company Stage
Series C
Total Funding
$196M
Headquarters
Boston, Massachusetts
Founded
2019
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Total Funding
$196M
Above
Industry Average
Funded Over
5 Rounds
Industry standards
Health Insurance
401(k) Company Match
Performance Bonus
Remote Work Options
Cohere Health India Global Innovation center recognized at ET Edge GCC Summit 2026. Pune/Bengaluru, India, June 15, 2026 - Cohere Health(R), the leading clinical intelligence and operations platform for health plans, has been named an "Impactful GCC" at the ET Edge GCC Summit 2026. The award recognizes Cohere Health India's Global Innovation Centre (GIC) for its contributions to innovation, operational excellence, talent development, and measurable business impact across the company's global operations. The ET Edge GCC Summit convenes industry leaders, policymakers, and GCC pioneers to celebrate organizations advancing significant transformation through their India operations. For Cohere Health, receiving this award emphasizes the growing role of its GIC in advancing the company's mission to optimize the speed, cost, and quality of care with shared clinical intelligence and connected operations. "This recognition reflects the dedication, innovation, and collaborative spirit of our teams, whose efforts continue to drive meaningful outcomes for our customers and the healthcare ecosystem," said Himanshu Gandhi, site general manager for Cohere Health India. "Central to our success is the close partnership with our global teams, how we work and deliver results at scale." Cohere Health expanded its global innovation strategy with the launch of its Hyderabad GIC in early 2026, strengthening the company's ability to support technology, product development, clinical intelligence, business operations and, ultimately, improved care delivery and health outcomes. India's GCC ecosystem is increasingly shaping how global healthcare organizations build capacity, fuel innovation, and scale operations. As Cohere Health expands its presence in India, the company remains committed to investing in local talent, deepening its clinical and technical expertise, and delivering value to the patients, providers, and health plans they serve. About Cohere Health Cohere Health's clinical intelligence and operations platform and agentic AI-powered solutions connect health plans' strategic goals and providers' needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines clinical and operational workflows across the care continuum-including policy, prior authorization, and payment accuracy-the company improves collaboration and reduces administrative burden, resulting in up to 9x ROI and 94% provider satisfaction. Cohere Health is recognized on TIME's World's Top HealthTech Companies 2025 list. Headquartered in Boston, Massachusetts, the company was co-founded in 2019 by Siva Namasivayam, who continues to serve as CEO. Company :-Kaizzen User :- Anjitha Eldho Email :[email protected]
Cohere Health Chief Medical Officer Dr. Brian Covino named to Modern Healthcare's 50 Most Influential Clinical Executives. BOSTON, June 8, 2026 /PRNewswire/ - Cohere Health(R), the leading clinical intelligence and operations platform for health plans, today announced that Dr. Brian Covino, Chief Medical Officer, has been named to Modern Healthcare's 2026 50 Most Influential Clinical Executives list. The annual awards program honors clinical leaders across the healthcare industry who use their medical backgrounds and executive positions to improve operations, clinical outcomes, and care delivery. Dr. Covino brings more than 25 years of experience as an orthopedic surgeon and value-based care leader to his oversight of Cohere Health's clinical strategy. His work centers on the development of responsible, clinical-led AI that streamlines healthcare decision-making and improves patients' access to appropriate care while keeping physicians in control. Cohere Health's clinical team has grown to more than 250 clinicians, including 70 specialty physicians. Partnering with the company's technology teams, these clinicians train AI systems to automate routine decisions while ensuring complex cases are always reviewed by a physician. This clinician-led approach enables health plans to approve 85% of prior authorization requests in real time and decrease administrative utilization management costs by 47%. Further, payment integrity teams achieve 87% greater efficiency, and in-workflow AI-assisted care suggestions have reduced adverse health outcomes by 43%. Discover more Doctors' Offices Medical Facilities & Services "Being recognized as one of the most influential clinical executives is an honor, but it truly reflects the work of the entire Cohere Health clinical team," said Dr. Covino. "As a surgeon, I saw how inefficiency affects the speed, cost, and quality of care. At Cohere Health, our clinicians are instrumental in advancing AI that is grounded in clinical evidence, human expertise, and trust-to support, not replace, physicians in delivering timely, appropriate care." Cohere Health's enterprise clinical intelligence platform streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, and more-to help health plans make faster, more consistent decisions. For more information on Modern Healthcare's 2026 50 Most Influential Clinical Executives and to view the full list, visit ModernHealthcare.com/50Most. About Cohere Health Cohere Health's clinical intelligence platform and agentic AI-powered solutions connect health plans' strategic goals and providers' needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum-including policy, prior authorization, payment accuracy, appeals, and more-the company improves collaboration and reduces burden, resulting in 9x ROI and 94% provider satisfaction. Cohere Health is recognized on TIME's World's Top HealthTech Companies 2025 list, on the 2025 Inc. 5000 list, and by numerous industry analysts. Discover more Health Insurance Medical Facilities & Services
Cohere Health has launched Cohere Surface, a data mining solution for health plans that uses agentic AI to provide transparency into claims overpayments. The platform replaces manual, vendor-dependent processes with automated intelligence that reveals why overpayments occur. The solution enables in-house teams to build and iterate rules in hours without IT dependency, whilst pre-configured rules reduce setup time. Agentic AI agents run rules continuously, process findings and support rule maintenance with human oversight. The platform connects structured and unstructured data including claims, contracts, benefits and clinical documentation. Cohere Surface is available standalone or as part of Cohere Health's Payment Integrity Suite. The company's solutions deliver 9x ROI and 94% provider satisfaction across payer-provider decision-making processes.
Cohere Health brings transparency to health plan data mining with adaptive claims intelligence. Published: April 28, 2026 New agentic AI offering delivers full visibility into why overpayments happen-enabling faster action, greater efficiency at scale, and continuous improvement. BOSTON (April 28, 2026) - Cohere Health(R), the leader in clinical intelligence solutions for health plans, today announced the launch of Cohere Surface(TM), a fundamentally new approach to data mining that replaces opaque, manual, and vendor-and IT-dependent processes with a transparent claims intelligence solution, powered by agentic AI. Health plans face significant operational hurdles in managing their data mining programs. In-house data mining operations suffer from long and laborious rule development timelines and maintenance cycles, requiring coordination between siloed functions. Service-led operations, built on contingency-based models, provide limited visibility into findings and profit from recurring errors. Legacy vendors aren't incentivized to improve data mining programs or surface new overpayment findings. Generic analytic tools lacking a native understanding of healthcare compound these challenges, piecing together fragmented data sources that fail to provide a complete picture of what is driving overpayments. "For too long, health plans have relied on opaque, contingency-based offerings that limit visibility into what's driving overpayments and how to prevent them. The same issues surface repeatedly, with no path to building something better," said Lalithya Yerramilli, SVP of payment solutions at Cohere Health. "With Cohere Surface, we're delivering a transparent, efficient, and flexible solution that truly breaks the status quo-empowering health plans to understand the 'why' behind their data, own that institutional knowledge, and continuously evolve their data mining strategies." Cohere Surface gives health plans the control and intelligence they need to scale and strengthen their data mining programs. Whether deployed in-house or via services, the solution provides full visibility into rule logic and overpayment patterns, including root causes. In-house teams accelerate their timelines by building and iterating on rules in hours-without IT dependency. Pre-configured rules meaningfully reduce set-up time, and automated monitoring ensures rules stay current as policies and other supporting documentation change. Agentic AI powers end-to-end workflows, with domain-specific AI agents that run rules continuously, process findings, and support rule maintenance with human oversight ensuring accuracy and compliance. Cohere Surface also connects both structured and unstructured data-including claims, contracts, benefits, policies, and clinical documentation-to create a comprehensive data fabric. This unified foundation gives health plans a complete, transparent view of the information needed to accurately adjudicate claims, continuously refine rules, and make proactive, data-driven decisions. The result is a data mining program that doesn't just find what's wrong-it builds the foundation for a smarter, more resilient payment integrity operation over time. Cohere Surface is available as a standalone solution and as part of Cohere Health's Payment Integrity Suite, which includes Cohere Validate(TM), Cohere Complete(TM) for PI, and Cohere Match(TM). For more information about Cohere Surface and how it modernizes data mining operations with advanced technology and transparency, visit https://www.coherehealth.com/payment-integrity/data-mining. Client outcomes may vary.
Cohere Health has appointed Dr Mark Leenay to its board of directors. Dr Leenay brings over 20 years of healthcare experience, including senior roles at WellCare, Optum and UnitedHealthcare, alongside expertise in medical cost management and health plan operations. The board-certified physician in family medicine and geriatrics previously served as COO of ChenMed, CEO of InHealth MD Alliance and EVP and Chief Medical Officer of WellCare Health Plans. He also held executive positions at UnitedHealth Group for a decade. Cohere Health develops clinical intelligence platforms and AI-powered solutions for health plans and providers. The company reports achieving eight times return on investment and 94% provider satisfaction with its enterprise platform that streamlines payer-provider decision-making across prior authorisation, payment accuracy and appeals.
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Industries
Enterprise Software
AI & Machine Learning
Healthcare
Company Size
501-1,000
Company Stage
Series C
Total Funding
$196M
Headquarters
Boston, Massachusetts
Founded
2019
Find jobs on Simplify and start your career today