C

Cohere Health

Builds software for healthcare authorizations

Medical Director Therapy

Physicians & SurgeonsConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • Complete a United States-based residency program in PM&R, Family Practice, Pediatrics, or Internal Medicine.
  • Hold board certification as an MD or DO and a current unrestricted state license to practice medicine, and maintain the necessary credentials for the position.
  • Have at least 5 years of clinical practice beyond residency or fellowship in PM&R, Family Practice, Pediatrics, or Internal Medicine.
  • Understand Therapy programs (PT/OT/SLP) in outpatient and inpatient settings.
  • Be comfortable learning and using new software tools.
  • Understand managed care regulatory structure and processes.
  • Be detail-oriented, flexible, and able to work autonomously with little supervision.

Responsibilities

  • Support the clinical content team by reviewing the company’s clinical decision guidelines and evidence-based literature.
  • Provide expert input on content intended to influence physicians’ medical care and improve patient outcomes.
  • Provide timely medical reviews that meet quality and timeliness parameters.
  • Make clinical determinations using evidence-based criteria, clinical acumen, evidence-based literature, and medical society guidelines.
  • Document communications and decisions accurately in Cohere workflow tools so members and providers can understand and reference the decisions.
  • Use the correct templates to document medical necessity decisions during case reviews.
  • Conduct timely peer-to-peer discussions with treating providers to clarify clinical information, explain review outcomes, and provide feedback on alternate treatment based on medical necessity criteria and evidence-based research.
  • Demonstrate professionalism, accountability, and service in interactions with Cohere teammates and providers.
  • Support delegated projects to build the team’s clinical expertise and efficiency.
  • Support delegated operational improvements and member/provider experience involving clinical review tasks.

Desired Qualifications

  • Have at least 1 year of managed care utilization review experience in Therapy (PT/OT/SLP).
  • Hold licensure in AR, MO, MN, NC, IN, TX, or NE; be willing to obtain additional state licenses with Cohere’s support.

About the Company

Cohere Health

Builds software for healthcare authorizations

Cohere Health builds clinical software and provides review services for health insurers. Its Cohere Unify platform helps teams handle prior authorization, appeals, care management, and payment integrity by organizing medical records and applying plan policies to requests and claims. AI tools extract clinical evidence and prepare recommendations, while nurses and physicians review cases that require clinical judgment. The company sells technology and delegated review services to health plans, which can use its software within their own teams or outsource selected workflows. Cohere Health was founded in 2019 and is headquartered in Boston, Massachusetts.

Company size
501-1,000
Company stage
Series C
Total funding
$196M
Headquarters
Boston, MA
Founded
2019

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