Associate Medical Director, Wound Care at Cohere Health

United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medical Utilization ManagementIndustries

Requirements

Completed US-based residency program in General Surgery, Surgical Subspecialties, Internal Medicine, or Emergency Medicine (MD/DO path) OR Completed US-based 3-year CPME-approved residency program in Podiatry (DPM path)
Board certification as an MD or DO with a current unrestricted state license to practice medicine (MD/DO path) OR Board certification by appropriate specialty board as a DPM with a current unrestricted state license to practice podiatry (DPM path); must maintain necessary credentials to retain the position
3+ years experience in Wound Care Management (MD/DO path) OR Experience in Wound Care Management (DPM path)
5+ years of clinical practice beyond residency/fellowship
Nice to Haves: 1+ years of managed care utilization review experience; Membership in national and/or regional specialty societies; Licensure in MN, ND, or TX (willingness to obtain additional state licenses with company support)

Responsibilities

Provide timely medical reviews that meet Cohere’s stringent quality parameters
Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen
Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision
Use correct templates for documenting decisions during case review
Meet the appropriate turn-around times for clinical reviews
Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research
Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
Support projects specific to building the team's clinical expertise and efficiency, as delegated
Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated

Skills

Key technologies and capabilities for this role

Wound CareMedical ReviewEvidence-Based GuidelinesClinical DocumentationPeer-to-Peer DiscussionsGeneral SurgeryInternal MedicineEmergency MedicineBoard Certification

Questions & Answers

Common questions about this position

Is this position remote?

Yes, this is a fully remote opportunity with about 5% travel.

What benefits are offered?

Benefits include medical, dental, vision, life, disability insurance, and Employee Assistance Program.

What are the must-have qualifications for this role?

Candidates must have completed a US-based residency in General Surgery, Surgical Subspecialties, Internal Medicine, Emergency Medicine, or a 3-year CPME-approved Podiatry residency; board certification with current unrestricted license; 3+ years (MD/DO) or experience (DPM) in Wound Care Management; and 5+ years of clinical practice beyond residency/fellowship.

What is the company culture like?

This is a fast-paced environment that favors people who learn quickly, are hands-on, handle ambiguity, and communicate effectively with diverse backgrounds; it emphasizes professionalism, accountability, and service.

What makes a strong candidate for this role?

Strong candidates will have the must-have clinical credentials in Wound Care, plus nice-to-haves like 1+ years of managed care utilization review experience, membership in specialty societies, and licensure in MN, ND, or TX.

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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