Full-Time

Medical Director

Clinical Strategy, Cardiovascular

Posted on 7/18/2024

Cohere Health

Cohere Health

501-1,000 employees

Automates prior authorization in healthcare

AI & Machine Learning
Healthcare

Compensation Overview

$250k - $290kAnnually

+ Bonus

Senior, Expert

Remote in USA

Category
Physicians & Surgeons
Medical, Clinical & Veterinary
Required Skills
Communications
Management
Data Analysis
Requirements
  • Completed US-based residency program in Internal Medicine and Cardiology.
  • Board certification as an MD or DO with a current unrestricted state license to practice medicine
  • 5+ years of clinical practice beyond residency/fellowship
  • 5+ years experience in managed care or clinical strategy at a health plan, healthtech/solutions/services, expert consulting (partner-level), or related payer-facing roles
  • MBA or advanced degree in healthcare-related discipline preferred
  • Experience serving as the lead thinker / consulting partner, designing innovative clinical programs and interventions driving value for payers and their members
  • Success in building credibility, influence and partnership with key clients
  • Executive presence and ability to communicate effectively with partners / clients
  • Demonstrated ability to work collaboratively with highly cross-functional teammates and influence internal partner groups
  • Strong communication and team management / interpersonal skills
  • Strong leadership capabilities and ability to initiate and maintain cross-team relationships
Responsibilities
  • Lead the vision and evolution of the company’s clinical and digital care management offerings as the clinical subject matter expert, in collaboration with colleagues from Clinical Strategy, Analytics, Product Management, Operations, Growth, and other teams
  • Utilizing market data, consumer research, and patient analytics, spearhead new approaches to effective clinical delivery services, including the introduction of new technology and integrated paths
  • Provide physician leadership in the creation of comprehensive research packages, investigating specific clinical areas/offerings and strategic partners of interest to strengthen the offering. Then, execute on cultivating any external partnerships and/or vendor relationships as necessary
  • Create and expand client relationships by partnering with the Growth team to uncover client pain points and deliver solutions
  • Participate in the strategic planning for Cohere’s clinical and digital care management strategy
  • Provide strategic guidance of utilization management and medical policy programs/areas as necessary to support the clinical organization
  • Monitor performance of launched clinical programs and support continuous improvement

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 technologies like optical character recognition and machine learning. This approach allows for faster decision-making and reduces delays in patient care. The goal is to make the prior authorization process more efficient, benefiting healthcare providers, health plans, and patients.

Company Stage

Late Stage VC

Total Funding

$103.1M

Headquarters

Boston, Massachusetts

Founded

2019

Growth & Insights
Headcount

6 month growth

1%

1 year growth

0%

2 year growth

3%
Simplify Jobs

Simplify's Take

What believers are saying

  • Humana expanded Cohere's platform use, showing trust and potential for more partnerships.
  • Cohere raised $50 million, indicating strong investor confidence and growth potential.
  • KLAS award recognition highlights effectiveness, attracting more healthcare providers.

What critics are saying

  • Increased competition from AI-driven startups like Abridge threatens market share.
  • Flat healthcare IT deal activity may impact future funding opportunities.
  • Dependency on Humana partnership poses risk if challenges arise in the relationship.

What makes Cohere Health unique

  • Cohere Health automates prior authorization, reducing delays and administrative burdens.
  • The Cohere Unify platform integrates with EMR and uses OCR for fax submissions.
  • Machine learning and AI enhance decision-making based on health plan policies.

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Benefits

Health Insurance

401(k) Company Match

Performance Bonus

Remote Work Options

INACTIVE