Full-Time

Associate Medical Director

Cardiology

Confirmed live in the last 24 hours

Cohere Health

Cohere Health

501-1,000 employees

Automates prior authorization in healthcare

AI & Machine Learning
Healthcare

Compensation Overview

$200k - $300kAnnually

+ Bonus + Health Insurance + 401k

Senior

Remote in USA

Category
Physicians & Surgeons
Medical, Clinical & Veterinary
Requirements
  • Completed US-based residency program in Internal Medicine and fellowship program in Cardiology
  • Board certification as an MD or DO with a current unrestricted state license to practice medicine - reviewers must maintain necessary credentials to retain the position
  • 5+ years of clinical practice beyond residency/fellowship in Internal Medicine or Cardiology
  • 1+ years of managed care utilization review experience desirable
  • Membership in national and/or regional specialty societies
  • Licensure in AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable - you should be willing to obtain additional state licenses with Cohere's support
  • Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
  • Excels in a matrix organization
  • Excellent communication - written and spoken
  • Comfortable with technology - willing and able to learn new software tools
  • Understanding of managed care regulatory structure and processes
  • Detail-oriented, flexible, and able to work autonomously with little supervision
  • Consultant agrees to cooperate fully with Cohere by obtaining state licenses or registrations when requested by Cohere.
Responsibilities
  • Support the clinical development team in reviewing the company’s clinical decision guidelines and evidence based literature
  • Provide expert input on content and programs for influencing physicians in cardiovascular care to improve the quality of patient outcomes
  • Provide timely medical reviews that meet Cohere’s stringent quality and timeliness parameters
  • Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen
  • Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision
  • Use correct templates for documenting decisions during case review
  • Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research
  • Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
  • Support projects specific to building the team's clinical expertise and efficiency, as delegated
  • Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated

Cohere Health improves the prior authorization process in healthcare, which requires providers to get approval from health plans before delivering certain services. Their platform, Cohere Unify, automates and streamlines these requests by integrating with electronic medical records and using machine learning to speed up decision-making. This approach sets them apart from competitors by offering a Platform-as-a-Service model that health plans can license for their internal teams. The goal is to make the prior authorization process more efficient, benefiting patients and reducing costs for healthcare providers and health plans.

Company Stage

N/A

Total Funding

$103.1M

Headquarters

Boston, Massachusetts

Founded

2019

Growth & Insights
Headcount

6 month growth

9%

1 year growth

19%

2 year growth

64%
Simplify Jobs

Simplify's Take

What believers are saying

  • Cohere Health's recent $50 million equity raise indicates strong investor confidence and provides ample resources for further innovation and expansion.
  • The expansion of its partnership with Humana to cover diagnostic imaging and sleep services demonstrates the platform's scalability and effectiveness.
  • Being named a 2024 Built In Best Place to Work highlights a positive company culture, which can attract top talent and drive further growth.

What critics are saying

  • The digital health market is highly competitive, and maintaining a technological edge requires continuous innovation and investment.
  • Dependence on large partnerships, such as with Humana, could pose risks if these relationships were to change or dissolve.

What makes Cohere Health unique

  • Cohere Health's Cohere Unify platform uniquely integrates with EMRs and uses OCR to handle fax submissions, setting it apart from competitors who may not offer such comprehensive automation.
  • The company's focus on responsible AI and machine learning for automating prior authorization decisions ensures compliance with health plan policies, providing a competitive edge in accuracy and reliability.
  • Cohere Health's recognition through awards like the 2021 TripleTree iAwards and the KLAS Points of Light Award underscores its industry leadership and innovative approach.

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