Full-Time

Senior Clinical Informaticist

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

$95k - $115kAnnually

+ Bonus

Senior

Remote in USA

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Required Skills
Python
SQL
Data Analysis
Requirements
  • 5 years of working as clinical informatics and/or clinical content management in healthcare settings
  • Master's degree/ Bachelor's Degree in Health Administration, Public Health or other health related field of study (e.g. nursing, pharmacy, medical research, bioinformatics, engineering, or related field).
  • Strong understanding of clinical workflows, healthcare operations, quality improvement, and regulatory compliance.
  • Self-starter, able to work independently, able to succeed in a fast-paced, high intensity start-up environment
  • Strong understanding of current billing practices in provider facilities
  • Experience in working with clinical ontologies (SNOMED, RxNorm, ICD-10, LOINC, CPT, HCPCS, etc) and health interoperability standards (HL7, FHIR, USCDI) preferred
  • Experience developing and supporting patient risk stratification, claims encounter grouping, and modeling with data scientists/ analysts/ engineers.
  • Registered Nurse (RN), Certified Pharmacy Technician (CPhT), or other clinical certification (preferred)
  • Clinical informatics (e.g. CPHIMS, AHIC, ACHIP) preferred
  • Knowledge of STARs, HEDIS and other clinical / financial metrics in healthcare (preferred)
  • Familiarity (able to mostly read) with common data analysis tools and platforms (e.g., SQL, Python). Bonus points for the ability to write in these languages, but not required.
Responsibilities
  • Serve as the bridge between clinicians, data science, engineering in planning, implementing, validating, executing and maintaining optimization care strategy
  • Utilize data, industry trends, and best practices to support the development of consulting methodologies that will facilitate the use of health information technology
  • Supports data analytics, including quality of care measures and risk analysis, to identify opportunities to improve patient health outcome
  • Incorporating evidence based practice standards of care in the design and optimization of systems.
  • Translate high level clinical hypotheses into data (claims, member and/or attachment) analysis requirements
  • Solving complex problems utilizing critical thinking skills with minimal guidance.

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

12%

1 year growth

21%

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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