Account Manager, Provider Success at Cohere Health

United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, HealthtechIndustries

Requirements

Bachelor's degree
PMP desired but not required
Willing and able to travel up to ~30%
Strong communication skills with the ability to translate policy and process into provider-friendly language
5-10+ years of experience in the health solutions industry (e.g. account management, provider relations, client services, network development, or network operations)
Direct experience working with government healthcare programs, especially CMS, and engagement with provider and/or member populations
Strong relationship-building and negotiation skills, particularly in highly regulated or complex healthcare environments
Ability to independently prioritize across a large provider portfolio and focus effort where it has the highest impact
Familiarity with Medicare/Medicaid rules, managed care models, and prior authorization processes
Proven success managing

Responsibilities

Serve as the main point of contact (go-to resource) for providers, supporting education, training, communications, and general platform guidance
Address contracting or administrative questions and help practices understand how to optimize their auto-approval rates
Act as an escalation point for grievances, disagreements with clinical guidelines, and other high-touch needs
Support onboarding and ongoing engagement to ensure providers remain aligned with CMS/state requirements and Cohere workflows
Maintain strong working knowledge of regulatory requirements influencing prior authorization and utilization management
Partner with Compliance and Legal to surface potential risks or required communications
Identify non-adherence or performance trends, then design simple outreach campaigns (email, phone, educational touch points) that encourage positive behavior change
Share best practices and actionable tips to improve auto-approval performance
Ensure all provider interactions uphold HIPAA, privacy standards, and program integrity
Use reporting and scorecards to track portfolio health, identify issues, and surface opportunities to improve clinical quality and reduce manual review
Lead recurring check-ins, quarterly reviews, practice calls, workflow discussions to help teams improve approval rates and reduce pends/denials
Help practices optimize clinical protocols and prior-auth workflows to reduce friction and increase auto-approvals
Share relevant thought leadership with key strategic partners
Advise practice leadership on how to align Cohere configurations with financial and clinical goals (e.g., bundles, ancillary service alignment)
Recommend workflow improvements that accelerate review times and ensure compliance with CMS/state DOH obligations
Assist with onboarding new client networks and provider groups at scale
Manage high-volume provider onboarding initiatives and periodic refresh trainings as new providers join the network

Skills

Key technologies and capabilities for this role

Account ManagementProvider RelationsHealthcare ComplianceMedicaidMedicarePrior AuthorizationUtilization ManagementOnboardingStakeholder EngagementOutreach CampaignsRegulatory KnowledgeCMS RequirementsEscalation ManagementPerformance Analysis

Questions & Answers

Common questions about this position

Is the salary range specified for the Account Manager, Provider Success role?

This information is not specified in the job description.

Is this Account Manager position remote or does it require office work?

This information is not specified in the job description.

What key skills are needed for the Account Manager, Provider Success role?

Key skills include strong knowledge of regulatory requirements for prior authorization and utilization management, ability to design outreach campaigns, and proficiency in using reporting and scorecards to monitor performance.

What is the team culture like at Cohere Health for this role?

The Provider & User Management Team focuses on delivering a proactive, supportive, and partner-oriented experience to providers.

What makes a strong candidate for the Account Manager, Provider Success position?

Strong candidates have experience managing healthcare provider portfolios, handling escalations, driving proactive outreach for behavior change, and supporting compliance with CMS/state requirements.

Cohere Health

Automates prior authorization in healthcare

About Cohere Health

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. The goal is to make the prior authorization process more efficient, benefiting healthcare providers, health plans, and patients.

Boston, MassachusettsHeadquarters

2019Year Founded

$103.1MTotal Funding

LATE_VCCompany Stage

AI & Machine Learning, HealthcareIndustries

501-1,000Employees

Benefits

Health Insurance

401(k) Company Match

Performance Bonus

Remote Work Options

Risks

Increased competition from AI-driven startups like Abridge threatens market share.

Flat healthcare IT deal activity may impact future funding opportunities.

Dependency on Humana partnership poses risk if challenges arise in the relationship.

Differentiation

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.

Upsides

Humana expanded Cohere's platform use, showing trust and potential for more partnerships.

Cohere raised $50 million, indicating strong investor confidence and growth potential.

KLAS award recognition highlights effectiveness, attracting more healthcare providers.

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