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.

Related companies:

🏢 Omada Health

👥 501-1000💰 $80,000,000 Debt Financing about 2 years agoTherapeutics Medical Wellness Health Care

Website LinkedIn Email Facebook Twitter

🏢 Apollo.io

👥 501-1000💰 $100,000,000 Series D over 1 year agoSoftware Development

Website LinkedIn Email Facebook Twitter

🏢 Clover Health

👥 501-1000💰 $300,000,000 Post-IPO Equity over 3 years ago🫂 Last layoff almost 2 years agoMedical Health Insurance Hospital Health Care

Website LinkedIn Email Facebook Twitter

Jobs at this company:

Apply

🔥 Medical Director, Operations, Ortho/Spine

Posted 2 days ago

📍 United States

🧭 Full-Time

💸 270000.0 - 290000.0 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
Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
Excels in a matrix organization
Strong interpersonal, oral and written communication skills
Ability to work remotely and meet telephonically and/or via video with clinical colleagues and other personnel
Proficient in using a Mac laptop computer and the Google Workspace of applications
Comfortable with technology - willing and able to learn new software tools
Understanding of managed care regulatory structure and processes
Detail-oriented, flexible, and able to work autonomously with little supervision

💡 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 2 days ago

Apply

🔥 Product Manager

Posted about 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 about 2 months ago

Apply

🔥 RN Reviewer

Posted about 2 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 about 2 months ago

Apply

🔥 Weekend RN Reviewer

Posted about 2 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 about 2 months ago

Apply