The Provider Success Manager leads the end-to-end onboarding and engagement lifecycle for providers and client users to ensure a seamless experience. They act as the primary point of contact to drive platform adoption, monitor portfolio performance, and provide consultative support to optimize clinical workflows.
The Clinical Integrity Manager is responsible for executing and maintaining the integrity, scalability, and operational readiness of clinical programs and technology-enabled solutions. This role involves partnering cross-functionally to translate clinical strategy into scalable processes while ensuring compliance with regulatory requirements and evidence-based standards.
Lead clinical analytics projects by collaborating with multidisciplinary teams to formulate plans and build analytical solutions. Identify optimization opportunities through statistical data mining and predictive modeling to improve clinical value and program effectiveness.
The Clinical Training & Quality Specialist will implement clinical quality measurements and develop training programs to improve operational efficiency. They will audit clinical decisions, provide coaching to team members, and ensure compliance with NCQA and CMS standards.
The Sr. Manager will lead the L1 support team, overseeing ticket triage, SLA adherence, and operational workflows to ensure efficient client issue resolution. They will also drive process improvements, manage user provisioning, and coordinate cross-functionally with engineering and product teams.
The Medical Director will perform medical necessity reviews using evidence-based guidelines and provide clinical input to support the company's decision-making tools. They will also conduct peer-to-peer discussions with providers to clarify clinical information and ensure high-quality patient outcomes.
Lead and develop a high-performing data platform engineering team while overseeing the execution of complex data initiatives. Partner with cross-functional stakeholders to ensure technical excellence, operational reliability, and scalable data foundation growth.
The strategist will consult with PaaS clients to design and execute robust automation programs for prior authorization decisioning. They will also translate complex requirements into technical blueprints and collaborate with cross-functional teams to drive platform value and continuous improvement.
The Clinical Configuration Analyst will manage the technical configuration of platform requirements for PaaS clients to support prior authorization automation. They will collaborate with cross-functional teams to test functionality, resolve technical issues, and serve as a subject matter expert throughout the customer lifecycle.
Lead a team of 20+ engineers across multiple squads to build and maintain clinical operations workflows. Oversee production reliability, technical direction, and the professional growth of direct reports and technical leads.
Lead the design and implementation of large-scale, reliable data pipelines while mentoring junior engineers to raise team standards. Collaborate with cross-functional stakeholders to ensure data products are performant, compliant, and trustworthy.
The analyst will collaborate with multidisciplinary teams to derive insights from healthcare data to improve clinical program effectiveness and patient outcomes. They will also build analytical reporting solutions and identify optimization opportunities using statistical modeling to support strategic decision-making.
The Medical Director will perform clinical reviews to determine medical necessity using evidence-based guidelines and clinical acumen. They will also provide expert input on clinical content and conduct peer-to-peer discussions with treating providers to improve patient outcomes.
The Clinical Reviewer will conduct medical necessity reviews for therapy services by applying evidence-based guidelines and clinical acumen. They will also engage in peer-to-peer discussions with providers to clarify clinical information and document decisions within the company's workflow tools.
The Clinical Reviewer will determine the medical appropriateness of musculoskeletal and orthopedic services by applying evidence-based guidelines. They will also conduct peer-to-peer discussions with providers and document clinical decisions within the company's workflow tools.
The Clinical Reviewer will determine the medical appropriateness of services by applying evidence-based guidelines and clinical acumen. They are responsible for conducting timely peer-to-peer discussions and accurately documenting all clinical decision-making within the company's workflow tools.
You will independently deliver full-stack features and improvements for healthcare technology, owning the design, implementation, and deployment process. You will also collaborate with product and QA teams to debug production issues and mentor junior team members.
The Client Support Specialist is responsible for investigating, triaging, and resolving technical product bugs while maintaining clear communication with stakeholders. They will monitor bug trends and collaborate with cross-functional teams to improve support processes and ensure high-quality service.
Conduct comprehensive MS-DRG and APR-DRG coding reviews to ensure accuracy in reimbursement and identify overpayments. Prepare clear, well-supported audit findings while maintaining compliance with industry regulations and company standards.
The Senior Workforce Management Analyst will optimize service and clinical operations by managing the WFM platform and aligning staffing levels with strategic goals. They will drive process improvements, conduct ROI modeling, and provide actionable data insights to support operational performance.
The Staff Software Engineer will lead the design, development, and scaling of AI-powered healthcare payment solutions while mentoring junior engineers. They will drive technical strategy, ensure operational readiness, and collaborate across cross-functional teams to deliver high-quality, performant software.
The VP of Payer Sales will develop and execute strategies to drive revenue growth and expand market presence across the Western U.S. region. They will lead and mentor a sales team while cultivating high-level relationships with key stakeholders at payer organizations.
Lead an agile team in designing and scaling resilient healthcare integration systems and distributed architectures. Drive technical excellence by mentoring engineers and partnering cross-functionally to deliver secure, high-performing enterprise solutions.
The manager will own the end-to-end delivery and strategy of the inpatient platform across multiple health plan clients. They will coordinate cross-functional efforts between Product, Engineering, Clinical Operations, Analytics, and Client Experience to ensure successful program execution and value realization.
The Senior Integration Analyst will lead the technical analysis and design of complex healthcare interoperability solutions between the Cohere platform and external systems. They will manage client-facing integration discovery, define technical specifications, and coordinate cross-functional teams to ensure reliable data exchange and system performance.
The Senior Clinical Informaticist will bridge clinical expertise and data science to design and validate digital health solutions. They will lead ontology mapping, terminology management, and ensure the integrity of AI-driven healthcare tools.
The Lead Client Analyst will consult with PaaS clients to design and execute automation programs while translating complex requirements into technical blueprints. They will also analyze authorization data to drive platform performance and ensure client KPIs are met throughout the customer lifecycle.
Manage and mentor a team of analysts while consulting PaaS clients on designing and executing optimal decision automation programs. Partner with cross-functional teams to translate complex client requirements into technical blueprints and ensure platform performance meets key KPIs.
Draft and refine patient-facing adverse determination communications to ensure they are clear, accurate, and compliant with regulatory standards. Collaborate with clinicians and policy experts to translate complex medical information into human-centered language while maintaining consistency across all documentation.
The Senior Director will lead executive relationships with major health plan clients to drive long-term account growth and retention. They will serve as an internal executive sponsor, collaborating across departments to ensure client success and identify expansion opportunities.
The Medical Policy Writer will draft, refine, and finalize medical policy documents based on current scientific evidence and clinical best practices. They will also partner with clinical leadership to ensure policy compliance with CMS guidelines and maintain the policy repository.
Own end-to-end technical integration design and execution for enterprise healthcare customers from pre-sales through production. Design system architectures that bridge customer IT environments with Cohere's AI-first platform while building reusable integration patterns.
Lead the vision and evolution of clinical and digital care management offerings in Diagnostic Imaging as a subject matter expert. Collaborate cross-functionally to design innovative clinical programs and support growth efforts through client-facing strategic discussions.
Lead the coordination and delivery of compliance and regulatory reporting initiatives by partnering with Compliance, Business Intelligence, and Operations teams. Manage the end-to-end reporting workflow, including requirements gathering, prioritization, and validation of recurring and ad hoc reports.
Perform prospective, concurrent, and retrospective medical necessity reviews to ensure cost-effective and high-quality care. Collaborate with Medical Directors and providers to align on clinical decisions and document reviews according to established protocols.
Maintain the availability and resilience of AWS-hosted healthcare systems and MERN stack applications. Balance time between live incident remediation, data pipeline operations, and engineering automated solutions to eliminate operational toil.
Conduct comprehensive professional and facility coding reviews to ensure accuracy in code assignment and reimbursement. Identify overpayments and craft well-supported audit findings based on AHA Coding Clinic Guidelines and regulatory standards.
Conduct comprehensive professional and facility coding reviews to ensure accuracy in code assignment and maximize overpayment identification. Utilize advanced DRG encoder tools and industry guidelines to craft well-supported audit findings and maintain compliance.
Oversee and develop a team of RN Reviewers to ensure performance metrics and quality standards are met. Manage daily operational activities, including productivity reports, timeliness tracking, and process efficiency improvements.
Conduct medical necessity reviews and prepare compliant clinical determinations and correspondence for members and providers. Collaborate with Medical Directors to ensure evidence-based decisions align with regulatory and accreditation standards.
Conduct quantitative analyses on healthcare costs and clinical outcomes to optimize auto-decisioning strategies and product performance. Develop reporting solutions and data visualizations to provide actionable insights for internal stakeholders and clients.
Lead the development of scalable, reliable platform infrastructure while driving deployment and release strategies to improve speed and safety. Partner cross-functionally to establish observability and SRE practices while mentoring teams on platform and reliability best practices.
Physicians will deliver on musculoskeletal and orthopedic programs by determining the medical appropriateness of services through clinical review and application of evidence-based guidelines. Key duties include providing timely medical reviews, accurately documenting decisions, and conducting peer-to-peer discussions with treating providers.
Design, build, and deploy advanced machine learning systems for various use cases while collaborating with cross-functional teams. Lead model development across the ML lifecycle and drive experimentation tied to business outcomes.
The Associate Medical Director will review clinical information and apply evidence-based guidelines to determine the medical appropriateness of services within Cohere’s Cardiology program. This role involves providing expert input on clinical decision guidelines and conducting peer-to-peer discussions with treating providers.
The Senior Business Analyst will support the execution and continuous improvement of clinical programs by providing data, documentation, and process discipline. This role involves transforming program strategy into deliverables such as dashboards and performance reports to ensure program success.
