Clinical Policy Specialist

Summary

Join Cohere Health as an Associate, Clinical Policy Specialist and contribute to improving patient care by implementing Medicare, Commercial, and Cohere policies within our product. You will play a key role in policy design and implementation, reviewing policy content and ensuring optimal configuration for clinical review. This position directly impacts clinicians and patients. Success in this role requires strong attention to detail, technical skills, and a passion for improving the U.S. healthcare system. The ideal candidate is a self-directed, empathetic team player who thrives in a fast-paced startup environment. Cohere Health offers a competitive salary and benefits package.

Requirements

• Tech savvy and detail oriented
• Must be knowledgeable of multiple software programs (Microsoft Word, Excel, Google Drive)
• Understanding of medical terminology, procedures, and diagnoses
• Knowledge of common disease processes, treatments, and tests
• Strong communication skills, listening effectively and asking for clarification when necessary
• Ability to work independently and as part of a team
• You are passionate about improving the U.S. healthcare system and helping ensure every patient receives the best care possible
• You are self-directed, confident, and thrive working in a fast-paced startup environment
• Education: Bachelor's Degree (BA/BS) required
• Work Experience: 6 months of related experience working for a payer or multi-specialty provider organization, or comparable experience with a healthcare technology or managed services vendor

Responsibilities

• Review healthcare policy documentation and data for discrepancies and missing information and resolve discrepancies
• Enter healthcare policy data including policy text, procedure codes, and diagnosis codes into Cohere Health’s product
• Perform routine quality assurance checks
• Implement solutions that help our internal teams comply with regulations for medical services
• Prepare educational materials on updates to internal customers
• Contribute ideas on how to best organize and represent information based on internal customer and product needs

Benefits

• Health insurance
• 401k
• Bonus
• Salary range: $50,000 to $60,000 annually