Medical Director, Operations, Cardiovascular at Cohere Health

United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, HealthtechIndustries

Requirements

Board-certified Cardiologist (MD/DO) with active, unrestricted U.S. medical license
Completed residency in Internal Medicine and fellowship in Cardiology
5+ years of post-training clinical experience
Strong communicator who thrives in a fast-paced, remote, collaborative environment
Organized multitasker with excellent attention to detail and follow-through
Tech-savvy and comfortable learning new digital tools (Google Suite, Mac)
Solid understanding of managed care processes and regulatory standards

Responsibilities

Lead and inspire a team of Cardiology Associate Medical Directors performing clinical prior authorization reviews and peer-to-peer discussions
Drive operational excellence across a fully remote team, fostering collaboration and accountability
Conduct clinical reviews and make evidence-based determinations that meet quality and turnaround standards
Engage with treating providers to discuss cases, clarify clinical details, and guide on evidence-based alternatives
Partner on the development and review of medical policies and clinical guidelines
Maintain up-to-date medical licensure and stay informed on the latest in cardiology care and regulatory guidance

Skills

Cardiology

Board-certified MD/DO

Internal Medicine Residency

Cardiology Fellowship

Utilization Management

Managed Care

Medical Licensure

Clinical Reviews

Peer-to-Peer Discussions

Medical Policies

Regulatory Standards

Google Suite

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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