Company Overview:
Cohere Health is a fast-growing clinical intelligence company that’s improving lives at scale by promoting the best patient-specific care options, using cutting-edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health plans covering over 15 million lives, while our revenues and company size have quadrupled. That growth combined with capital raises totaling $106M positions us extremely well for continued success. Our awards include: 2023 and 2024 BuiltIn Best Place to Work; Top 5 LinkedIn™ Startup; TripleTree iAward; multiple KLAS Research Points of Light awards, along with recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.
Opportunity Overview:
Working on a small, fast-paced team, and reporting into the Director of Commercial Strategy, you will play a foundational role in the development and delivery of an Cohere’s inpatient product, which combines deep clinical expertise and cutting edge AI to improve clinical review accuracy and efficiency for inpatient admission authorizations. You will apply your clinical expertise to review historical cases and synthesize review patterns as a key input to automation build.
Last but not least: People who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.
What you will do:
- Review historical inpatient admission authorizations
- Synthesize patterns across reviews
- Help design algorithms for evaluating inpatient admission medical necessity
- Help build ML models that read clinical notes
- Consult on review automation product design
Your background & requirements:
- Registered Nurse (RN), associate or bachelor’s degree
- 7+ years of experience conducting payer UM reviews for acute inpatient authorizations
- 3+ years of experience in acute care hospital setting as a bedside nurse
- Clinical Rigor: Consistently performs high quality reviews, demonstrating strong command of complex cases
- Operational Expertise: Deep understanding of payer end-to-end inpatient UM workflows, regulatory requirements (e.g., CMS 2MN Rule), and guidelines (i.e., MCG, IQ)
- Analytical: Ability to identify patterns across reviews, summarize in a report, and generate actionable data-driven recommendations
- Communication: Proactive, comprehensive, clear, and concise (a)synchronous communication
- Technology Use: Proficient in key technology applications (e.g., MacBook, Slack, Google Suite, UM review tools)
- Leadership: Go-to resource for peers on best practices, and drives continuous improvement across the UM team
- Ownership: Takes ownership of work and is a self-starter
- Agility: Comfort operating in a fast-paced startup environment
- Perspective on AI: Passion for and conceptual understanding of how AI can be used to optimize UM
- Entrepreneurial: Natural inclination to look for ways to improve the status quo
We can’t wait to learn more about you and meet you at Cohere Health!
Equal Opportunity Statement:
Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.
The salary range for this position is $75,000 to $85,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.
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What We Do
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.
Why Work With Us
Cohere Health brings together a community of healthcare and technology team members, passionate about changing the challenging parts of healthcare. If you enjoy solving challenging problems and learning about healthcare, then Cohere Health is a great career choice.
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Cohere Health Teams
Cohere Health Offices
Remote Workspace
Employees work remotely.
Cohere employees work from 48 different states throughout the US - Cohere hosts retreats at the Boston office in the North End.
