Associate Medical Director, Diagnostic Imaging

Summary

Join Cohere Health, a rapidly growing clinical intelligence company, as a physician specializing in radiology and diagnostic imaging. You will play a crucial role in determining the medical appropriateness of services, reviewing clinical information, and applying evidence-based guidelines. This position requires a strong understanding of managed care, excellent communication skills, and the ability to work both independently and collaboratively. The ideal candidate will have 5+ years of clinical practice beyond residency and be board-certified. Cohere Health offers a competitive salary, comprehensive benefits, and a supportive work environment.

Requirements

• Completed US-based residency program in Diagnostic Radiology
• 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 Radiology

Responsibilities

• Support the clinical content team in reviewing the company’s clinical decision guidelines and evidence based literature
• Provide expert input on content for influencing physicians in medical 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 and knowledge of evidence based literature and medical society guidelines
• 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 medical necessity 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
• Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
• Support projects specific to building the team's clinical expertise and efficiency, as delegated
• Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated

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
• Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
• Excels in a matrix organization
• Excellent communication - written and spoken
• Comfortable with technology - willing and able to learn new software tools
• Understanding of managed care regulatory structure and processes
• Detail-oriented, flexible, and able to work autonomously with little supervision
• Consultant agrees to cooperate fully with Cohere by obtaining state licenses or registrations when requested by Cohere

Benefits

• Health insurance
• 401k
• Bonus