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Full-Time

Medical Director

Clinical Strategy, Cardiovascular

Confirmed live in the last 24 hours

Cohere Health

Cohere Health

501-1,000 employees

Automates prior authorization in healthcare

Healthcare
Enterprise Software

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, setting Cohere Health apart from competitors who may not offer such comprehensive automation. The company's goal is to enhance patient outcomes and reduce costs for healthcare providers and health plans.

Company Stage

Series C

Total Funding

$122.2M

Headquarters

Boston, Massachusetts

Founded

2019

Growth & Insights
Headcount

6 month growth

11%

1 year growth

22%

2 year growth

66%
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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.