Fully Remote | Non-Clinical Opportunity | Your Clinical Expertise Reimagined

Make a real impact on patient care with a fast-growing, innovative clinical intelligence company! We combine cutting-edge AI with deep clinical expertise to ensure patients receive the best care.

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Opportunity Highlights:

• Fully Remote Role: Work from the comfort of your home.
• Focus on Utilization Management: Review cases within specific speciality areas to determine medical necessity using evidence-based guidelines.
• Impact Millions: Contribute to a company impacting over 15 million patient lives.
• Influence & Collaboration: While not a people leader role, you'll influence care decisions and can participate in ad hoc projects.
• Collaborative Team: Work alongside non-clinical intake specialists and nurses, reporting to the Medical Director, Operations
• Fast-Paced & Innovative: Thrive in a dynamic environment where learning and communication are key.
• Award-Winning Culture: Join a company recognized as a great place to work.

What You'll Do:

• Conduct timely remote medical reviews of cases.
• Apply evidence-based criteria and your clinical judgment for medical necessity determinations.
• Clearly document all communication and decisions in our workflow tools.
• Utilize templates for efficient case review documentation.
• Meet turnaround times for clinical reviews.
• Engage in peer-to-peer discussions with treating providers to clarify information and explain review outcomes.
• Maintain high levels of professionalism and service.
• Contribute to projects enhancing clinical expertise and efficiency (as needed).
• Support operational improvements related to clinical review tasks (as needed).

What You'll Bring:

• Completed US-based residency
• Board certification (MD or DO) with a current, unrestricted US state medical license.
• 5+ years of clinical practice experience post-residency/fellowship.

About Cohere Health

Cohere Health is a clinical intelligence company delivering AI-powered intelligent prior authorization solutions, which streamline patients’ access to quality care by aligning their physicians and health plans for improved collaboration, transparency, and care coordination. Cohere works with nearly 600,000 providers and processes more than 12 million prior authorization requests annually, using AI to auto-approve up to 90% of requests for millions of health plan members around the country. The company was recognized twice in the Gartner® Hype Cycle™ for U.S. Healthcare Payers, is a Top 5 LinkedIn™ Startup for 2023 & 2024, and is a three-time KLAS Points of Light award recipient. Its investors include Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners.