Cohere Health

👥 501-1000💰 $50,000,000 Series C about 1 year agoSaaS Consumer Software Health Care Software💼 Private Company

Cohere Health is a technology-focused company that engages in the development and implementation of innovative solutions in the health sector, seeking to optimize healthcare delivery and improve patient outcomes.

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Jobs at this company:

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🔥 Deputy General Counsel

Posted about 15 hours ago

📍 United States

🧭 Full-Time

💸 170000.0 - 210000.0 USD per year

🔍 Healthcare

🔧 Requirements

10+ years legal experience
3-5 years experience as in-house counsel for a healthcare organization
Active member in good standing with the state bar
Excellent judgement, analytical, problem-solving and negotiation skills
Excellent written and verbal communication skills, especially in the areas of contract drafting and explaining legal and business risks to business clients
Strong business acumen
Working knowledge of federal and state laws and regulations applicable to the health insurance and health care industry, especially Medicare and Medicaid

💡 Responsibilities

Support the transactional and contract needs of, and provide counsel on issues concerning company business, specifically the company’s product offering to its health insurer customers and commercial partners
Provide legal and transactional support to vendor contracting and to the Company’s marketing group
Assist the General Counsel and Chief Compliance Officer with corporate and governance matters
Provide legal advice and support to senior management and departments
Draft, review, and negotiate contracts and agreements
Develop and implement legal strategies to minimize risk
Collaborate with external counsel
Conduct legal research and analysis to support decision-making

SQLComplianceRisk Management

Posted about 15 hours ago

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🔥 Medical Director, Operations, Ortho/Spine

Posted 28 days ago

📍 United States

🧭 Full-Time

💸 270000.0 - 295000.0 USD per year

🔍 Healthcare

🔧 Requirements

Completed US-based residency program in Orthopedic Surgery; Spine surgery fellowship training or extensive clinical experience required
Board certification as an MD or DO with a current unrestricted state license to practice medicine - must maintain necessary credentials to retain the position
5+ years of clinical practice beyond residency/fellowship

💡 Responsibilities

Lead a team of Orthopedic Surgery and Spine Surgery Associate Medical Directors responsible for prior authorization clinical reviews and peer-to-peer discussions
Inspire and motivate team members to perform at their best
Demonstrated ability to oversee and collaborate with staff
Proven experience managing a remote workforce and operating efficiently in a virtual environment
Identify potential problems and points of friction and working to find solutions in order to maximize efficiency and revenue
Develop and document standard operating procedures
Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
Support the clinical guidelines team in developing and reviewing the company’s clinical decision guidelines in conjunction with client guidelines and directives
Perform timely review of Medical Coverage Policies for our clients
Participate in internal and external audits of physicians and nurses
Participate in recruiting of AMDs as business needs grow
Participate in developing and implementing of physician training
Support MSK strategy team focused on Spine strategy. This includes new strategy around site of service, level of care, temporary codes, G&A alignment, policy work and other areas such as reviewer efficiency enhancements, client facing meetings, etc.
Help to promote and maintain professional relationships or partnerships with Spine medical specialty societies, specifically NASS.
Be willing to travel as needed for client facing meetings or strategic onsite meetings
Maintain awareness of any changes in the literature, standard of care, or regulatory guidance impacting the criteria by which the company reviews service requests
Maintain necessary credentials and immediately informs Cohere of any adverse actions relating to medical licenses and/or board certifications
Perform other duties as delegated

LeadershipProject ManagementPeople ManagementOperations ManagementCommunication SkillsAnalytical SkillsOrganizational skillsInterpersonal skillsClient relationship managementStrategic thinking

Posted 28 days ago

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🔥 Product Manager

Posted 2 months ago

📍 United States, Canada

🧭 Full-Time

💸 120000.0 - 145000.0 USD per year

🔍 Digital Health

🔧 Requirements

Minimum of 3 years of experience in product management in care management, digital health, or adjacent industries with a focus on driving efficiencies in clinical workflows at scale.
Track record of “0 to 1” product experience, with the ability to synthesize complex insights and run experiments to develop a product strategy for the team.
Proven experience synthesizing business and customer needs to independently form (and execute on) a product roadmap.
Exceptional analytical capabilities and a dogged determination to always make decisions and validate hypotheses informed by data.
Strong problem-solving skills and willingness to roll up one’s sleeves to get the job done.
Demonstrated ability to lead and mentor cross-functional teams in a matrix organization.

💡 Responsibilities

Work with the Review Product Lead to prioritize initiatives that address the highest impact opportunities to drive more efficiency and better decision making in Nurse and Medical Director workflows.
Independently align stakeholders, research, design and engineering to execute against your roadmap.
Leverage data-driven insights, a deep knowledge of your end users, and collaboration with Cohere’s RNs and MDs to deliver automation at scale.
Gain a deep understanding of the decisions made by patients, providers, and payers that leads to how patient care is delivered. Translate user pain points into actionable opportunities with measurable impact.
Work closely with Design, Product Engineering, Machine Learning, Data Science, and User Research teams to deliver solutions that have demonstrable and measurable impact.
Define key success metrics and ensure all solutions are measurable to demonstrate value to both internal and client stakeholders.
Act as a product evangelist of Cohere’s Review product to both internal stakeholders and client leadership.

Data AnalysisMachine LearningProduct ManagementCross-functional Team LeadershipStakeholder management

Posted 2 months ago

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🔥 RN Reviewer

Posted 3 months ago

📍 United States

💸 32.0 - 35.0 USD per hour

🔍 Clinical intelligence

🔧 Requirements

Registered Nurse with active, unencumbered license in state of residence.
Minimum 3 years of clinical experience.
Required Utilization Management experience.
Experience in acute care and/or post-acute care environments.
Preferred experience includes HEDIS RN/abstraction, Legal RN, Utilization Review.
Strong communication skills, both written and oral.
Understanding of NCQA and CMS standards.
Proficient in using MCG guidelines.

💡 Responsibilities

Performs medical necessity review including inpatient, concurrent, prior authorization, retrospective, and treatment setting reviews.
Consults with Medical Directors regarding care that does not meet criteria.
Documents clinical information accurately and timely.
Maintains understanding of Cohere Health’s authorization and clinical criteria.
Identifies and refers members to appropriate healthcare programs.
Collaborates and educates with various stakeholders to ensure criteria consistency.
Ensures compliance with accreditation and regulatory requirements.
Participates in quality improvement activities.

Posted 3 months ago

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🔥 Weekend RN Reviewer

Posted 3 months ago

📍 United States

💸 33.0 - 35.0 USD per hour

🔍 Clinical intelligence

🔧 Requirements

Registered Nurse with active, unencumbered license in the state of residence.
Minimum of 3 years of clinical experience.
Utilization Management experience is required.
MCG certification is preferred.
Experience in acute or post-acute care environments is desired.
Understanding of NCQA and CMS standards.
Excellent written and oral communication skills.

💡 Responsibilities

Performs medical necessity review including inpatient, concurrent, prior authorization, and retrospective reviews to ensure appropriateness and compliance.
Communicates consistently with providers and facility staff to meet member needs.
Documents clinical information completely, accurately, and timely.
Maintains understanding of authorizations and clinical criteria.
Identifies clinical program opportunities and refers to healthcare programs.
Collaborates with various teams to ensure application of clinical criteria.
Ensures compliance with accreditation and regulatory requirements.
Supports quality improvement activities.

Posted 3 months ago

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🔥 Senior Healthcare Analytics Analyst

Posted 5 months ago

🧭 Full-Time

💸 100000.0 - 115000.0 USD per year

🔍 Healthcare

🔧 Requirements

5+ years experience working in an analyst role
Ability to use statistical analysis tools (such as SQL, R, or SAS) to extract insights from complex healthcare data sets, interpret trends, and derive actionable recommendations - experience with Athena preferred
1+ years experience building and/or maintaining dashboards and self service business intelligence tools such as Tableau or PowerBI
Understanding of healthcare systems, medical terminologies, clinical workflows, and regulations preferred
Experience interfacing with internal stakeholders and colleagues on the development and definition of client and program specific KPIs
Strong verbal and written communication skills will be essential to convey complex information to stakeholders and collaborate effectively with internal stakeholders and clients
Experience setting goals and meeting deadlines for multiple ongoing projects
Ability to identify issues within healthcare data and devise solutions
Ability to navigate ethical dilemmas in healthcare data management and analysis while upholding professional standards and integrity

💡 Responsibilities

Research, Build, Execute and Optimize auto decisioning strategy for new client implementations
Work with multiple types of healthcare data to build and maintain analytical and reporting solutions to support strategy and program decision making
Identify optimization opportunities based on analyses to improve auto-decisioning performance and drive increased value for clients
Perform quantitative analysis of health care cost, operational performance and clinical outcomes using claims and authorization data
Track cost, utilization and industry trends to inform stakeholders of solution performance and provide insights around opportunities to optimize clinical value for patients, providers and payers.
Prepare information for clients, build reports, data visualization and self service solutions for internal and external stakeholders
Develop, review, and analyze detailed data sets leveraged for client reporting/analytics
Collaborate with Insights team on rule refinement and metric tracking

Data visualization

Posted 5 months ago

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