Cohere Health is hiring a
Associate Medical Director

Summary

The job description is for a Cardiology reviewer role at Cohere Health, reporting to the Medical Director, Cardiology. The role involves reviewing clinical information, providing expert input on content and programs, and making timely medical reviews based on evidence-based criteria. The candidate should have completed a US-based residency program in Internal Medicine and fellowship program in Cardiology, be board certified as an MD or DO with a current unrestricted state license to practice medicine, and have 5+ years of clinical practice beyond residency/fellowship in Internal Medicine or Cardiology.

Requirements

• Completed US-based residency program in Internal Medicine and fellowship program in Cardiology
• Board certification as an MD or DO with a current unrestricted state license to practice medicine - reviewers must maintain necessary credentials to retain the position
• 5+ years of clinical practice beyond residency/fellowship in Internal Medicine or Cardiology

Responsibilities

• Support the clinical development team in reviewing the company’s clinical decision guidelines and evidence based literature
• Provide expert input on content and programs for influencing physicians in cardiovascular care to improve the quality of patient outcomes
• Provide timely medical reviews that meet Cohere’s stringent quality and timeliness parameters
• Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen
• Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision
• Use correct templates for documenting decisions during case review
• Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research

Preferred Qualifications

• 1+ years of managed care utilization review experience desirable
• Membership in national and/or regional specialty societies
• Licensure in AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable - you should be willing to obtain additional state licenses with Cohere’s support

Benefits

• #LI-Remote
• #BI-Remote