Configure, maintain, and test medical coverage policies in Cohere’s platform to ensure accuracy, clinical appropriateness, and compliance with industry standards. Monitor policy updates, advise internal teams and customers, address configuration feedback, and collaborate with clinical, product, engineering, writing, and utilization management teams to improve implementation and usability.
The analyst will consult with PaaS clients to design and execute robust prior authorization decision automation programs. They will also collaborate with cross-functional teams to translate requirements into technical blueprints and analyze performance data to drive continuous improvement.
The manager will lead a team to design and execute healthcare decision automation programs while partnering with cross-functional teams to translate client requirements into technical blueprints. They are responsible for managing client roadmaps, optimizing analytics frameworks, and ensuring portfolio KPIs are met through the customer lifecycle.
The Lead Forward Deployed Healthcare Analyst will consult with PaaS clients to design and execute robust prior authorization automation programs. They will translate complex requirements into technical blueprints and collaborate with cross-functional teams to drive continuous platform improvement and client success.
The Sr. Director will establish and manage the clinical RN review function at the Global Innovation Center in India, overseeing end-to-end operations for US payer clients. This role involves building a high-performing team, ensuring adherence to clinical guidelines and regulatory standards, and driving continuous quality improvement.
The Senior Commercial Counsel will lead commercial contracting efforts, including drafting and negotiating enterprise customer and SaaS agreements. They will also partner with internal stakeholders to provide legal guidance, mitigate risks, and support the company's product offerings and business objectives.
The Product Manager will drive the vision and roadmap for the Review Intake portfolio by collaborating with cross-functional teams to improve provider experience and operational efficiency. They will lead the product lifecycle from strategic planning to delivery, utilizing data and user research to solve complex healthcare problems.
The Pricing Analyst will develop and maintain pricing models to forecast profitability and revenue impact while providing core FP&A support. They will partner with cross-functional teams to review deal opportunities and present data-backed financial recommendations to leadership.
The Medical Director will perform clinical reviews to determine the medical appropriateness of orthopedic and spine surgery services based on evidence-based guidelines. They will also conduct peer-to-peer discussions with providers and document decisions within the company's clinical intelligence platform.
The VP of Strategic Accounts will lead the strategic planning and relationship management for large health plan clients to drive growth and retention. They will collaborate with internal teams, including sales and client success, to ensure client needs are met and value stories are effectively communicated.
The Data Scientist will analyze healthcare claims and authorization data to identify trends, outliers, and opportunities for improvement. They will also develop, train, and implement large language models and algorithms to support business decision-making and operational workflows.
The Director of Solutions Architecture will lead and manage a team of eight architects to design mission-critical healthcare solutions. They will partner with cross-functional teams to ensure delivery alignment, manage escalations, and establish quality standards for solution design.
The Senior Director, Solution Owner will lead the end-to-end success of complex customer implementations, managing business, clinical, and technical workstreams. They will serve as an executive-level counterpart to client leadership while driving cross-functional teams to meet deployment timelines.
The Senior Clinical Portfolio Manager will oversee the day-to-day execution and operational outcomes of the Speech Therapy program. They will coordinate across clinical strategy, analytics, and client success teams to ensure program delivery aligns with strategic objectives and performance metrics.
Lead and mentor a team of Applied Scientists to develop and deploy machine learning models that automate complex clinical and administrative workflows. Partner cross-functionally with Product, Engineering, and Clinical stakeholders to ensure solutions are scalable, reliable, and drive healthcare impact.
The Strategic Medical Director will lead the vision and evolution of clinical and digital care management offerings while serving as a subject matter expert for internal teams and clients. They will collaborate cross-functionally to translate clinical strategy into technology-enabled solutions and support growth initiatives through client engagement.
The Clinical Integrity Director manages the operational integrity, governance, and readiness of clinical programs and technology-enabled solutions. This role coordinates across cross-functional teams to ensure clinical requirements are met and operational readiness is maintained for product releases and client implementations.
The Senior Actuarial Support Analyst will design and maintain complex financial models to evaluate cost-saving initiatives and analyze prior authorization trends. They will act as a strategic advisor to leadership, providing actionable insights and reports to improve healthcare efficiency and cost outcomes.
The specialist will design and deliver training programs for RN and MD reviewers to ensure efficient queue management and platform adoption. They will collaborate with internal teams to maintain training toolkits and translate complex workflow customizations into effective educational materials.
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 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.
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 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 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.
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 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.
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.
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.
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.
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.
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.
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.
