Medical Director

Summary

Join Cohere Health as their Medical Director, Healthcare Policy! Reporting to the Chief Medical Officer, you will lead a team of medical writers, editors, and clinical policy specialists. This role involves developing and implementing medical coverage policies for various health plan clients, requiring client interaction and policy review. You will significantly impact patient care by creating and maintaining provider-facing content, ensuring alignment with evidence-based medicine. Success in this position requires strong leadership, communication, and collaboration skills within a fast-paced startup environment. The ideal candidate will have extensive experience in managed care, clinical strategy, and medical policy development.

Requirements

• Possess 5+ years of experience in managed care or clinical strategy at a health plan, healthtech/solutions/services, topical consulting (partner-level), or related payer-facing roles
• Hold a Medical Degree
• Have 5+ years of clinical, regulatory, or scientific writing experience
• Demonstrate a thorough understanding of scientific research
• Possess experience serving as a lead thinker/consulting partner, designing innovative clinical programs and interventions driving value for payers and their members
• Showcase success in building credibility, influence, and partnering with key clients
• Demonstrate the ability to work collaboratively and influence internal partner groups
• Exhibit strong communication and team management/interpersonal skills
• Display strong leadership capabilities and the ability to initiate and maintain cross-team relationships
• Have prior experience with medical policy and content development
• Possess knowledge of medical coding terminologies (HCPCs, CPT, ICD-10)
• Have a working knowledge of Medicare (including NCDs/LCDs), Commercial, and Medicaid medical policies
• Possess experience in reviewing clinical literature to understand the implications of policy changes
• Exhibit strong oral and written communication skills and the ability to interact within all levels of the organization
• Demonstrate the ability to maintain high-quality outputs by developing and enforcing organizational standards and efficiencies
• Demonstrate the ability to work in a fast-paced environment
• Be passionate about improving the U.S. healthcare system and helping ensure every patient receives the best care possible
• Be self-directed, confident, and thrive working in a fast-paced startup environment

Responsibilities

• Serve as editorial lead for clinical guidelines across various specialties
• Manage the content pipeline/roadmap for clinical specialties
• Create and enforce processes for developing, maintaining, and communicating medical policy and provider-facing content
• Review, update, and document revisions to established medical policies and communicate to key stakeholders
• Report on policy coverage across Cohere’s customers and specialty lines
• Assist Clinical Content departmental heads in strategic development and expansion of medical policies and provider-facing content
• Scope new content development projects to ensure timely delivery, meet all requirements, and maintain high quality
• Manage a team of Medical Writers, Editors, and Clinical Policy Specialists

Preferred Qualifications

• Hold an advanced degree in a healthcare-related discipline
• Have 5+ years of clinical practice beyond residency/fellowship

Benefits

• Health insurance
• 401k
• Bonus