Full-Time

Director – Clinical Programs

Diagnostic/Cardiac Imaging

Posted on 11/27/2024

Cohere Health

Cohere Health

501-1,000 employees

Automates prior authorization in healthcare

AI & Machine Learning
Healthcare

Compensation Overview

$160k - $180kAnnually

+ Bonus

Senior, Expert

Remote in USA

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary

You match the following Cohere Health's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • Bachelor's degree required (Preferred: MPH or an advanced degree in healthcare-related discipline, MBA, or nursing degree)
  • Licensed Clinician (Preferred: Radiology Technician, RN, OT, PT, ST, PharmD, PA, NP)
  • 10+ years experience in the areas of utilization management, clinical programs, and/or care management
  • 5+ years of experience leading direct reports or providing indirect leadership
  • 5+ years of experience at a health plan, risk-bearing entity, or utilization management vendor leading Imaging solutions that address administrative expenses, medical expenses and patient outcomes
  • Experience launching and scaling new tech-enabled healthcare products or services
Responsibilities
  • Own the execution of program goals and continuous improvement for Diagnostic/Cardiac Imaging clinical programs aimed at managing cost trends and improving health outcomes
  • Build, communicate, and routinely update the program strategic roadmap
  • Collaborate cross-functionally with Medical, Trend Innovation, Clinical Analytics, PaaS, Product, Operations, and other teams to design and execute clinical programs
  • Develop and manage relationships with external clients, clinical partners, and business partners, in collaboration with Business Development and Strategic Accounts leaders
  • Establish, communicate, and be accountable for achieving goals of solutions and partnerships; monitor outcomes and lead initiatives for clinical and business optimization
  • Responsibility for additional clinical specialty areas may be included in this role’s scope of responsibility as Cohere grows
Desired Qualifications
  • Preferred: MPH or an advanced degree in healthcare-related discipline, MBA, or nursing degree
  • Preferred: Radiology Technician, RN, OT, PT, ST, PharmD, PA, NP

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 technology 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 its use of Cohere's platform for diagnostic imaging and sleep services.
  • Cohere Health raised $50 million to meet demand for AI-driven prior authorization.
  • Cohere's platform processes 5.5 million authorizations annually, benefiting 15 million members.

What critics are saying

  • Increased competition from AI-driven startups like Abridge threatens market share.
  • Flat deal activity in healthcare IT indicates a challenging investment environment.
  • S32's new General Partner may boost funding for competing healthcare startups.

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