Medical Director, Clinical Strategy, Diagnostic Imaging

Summary

Join Cohere Health, a rapidly growing clinical intelligence company, as a Radiology Physician to significantly impact patient care. This critical role involves shaping clinical program design, strategy, and innovation. You will collaborate with clients, specialty societies, and internal teams to enhance clinical quality, leverage technology, and develop impactful policies. The position requires extensive experience in radiology, managed care, and utilization management, along with strong communication and leadership skills. Cohere offers a competitive salary, comprehensive benefits, and a supportive, growth-oriented environment.

Requirements

• Completed US-based residency program in Radiology
• Board certification as an MD or DO with a current unrestricted state license to practice medicine - physicians must maintain necessary credentials to retain the position
• 5+ years of clinical practice beyond residency/fellowship in Radiology
• 5+ years experience in managed care or clinical strategy at a health plan, healthtech/solutions/services, expert consulting (partner-level), or related payer-facing roles
• 2 years of Utilization Management experience within a health plan or vendor
• Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
• Excellent communication - written and spoken
• Comfortable with technology - Proficient in Google Docs / Sheets / Slides or Microsoft Word / Excel / PPT, willing and able to learn new software tools
• General understanding of AI/ML
• Detail-oriented, flexible, and able to work autonomously with little supervision
• Executive presence and ability to communicate effectively with partners / clients
• Strong leadership capabilities and ability to initiate and maintain cross-team relationships
• Able to work in a fast paced environment, make decisions quickly and manage a busy calendar that changes frequently
• Willingness to travel

Responsibilities

• Support Cohere’s clinical credibility by deepening relationships with current clients and future clients
• Develop relationships with specialty societies and secure partnerships
• Attend annual society meetings and manage quarterly meetings (or more frequent) with society partners
• Help recruit new members as needed for new specialties
• Conduct quarterly virtual meetings
• Attend the annual in-person meeting (Dallas 1/31/2025)
• Support ad-hoc client requests with partnership of operational MDs (case review, policy questions, audits, etc)
• Support Cohere’s growth team with prospective clients, engaging with the health plans medical directors during activation phase of implementation
• Provide thought leadership, partnering with the marketing team for white papers, content ideation, webinars, specialty society meetings
• Determine provider quality/provider tracks
• Ensure the metrics are clinically relevant and fair, consider practice type etc
• Use specialty society data, quality metrics when possible
• Apply appropriate use criteria from societies
• Obtain physician input on fast track, supported track, and Motive measures
• Partner with Data science-use clinical outcomes to design predictive models to understand good and bad outcomes from procedures/surgeries
• These models can help move the patients towards the correct next step on the care path
• Use clinical outcome data to inform Cohere’s proprietary policies
• Provide expert input on trend innovation/programs within specialty area to improve patient outcomes
• Partner with the Clinical Intelligence team to continually improve current rules and develop advanced rules using ML models and AI capabilities
• Leverage technology to streamline/ improve automation for our internal stakeholders (RN and MD) for high volume reviews (PT) to drive efficiencies
• Leverage society clinical practice guidelines (CPG), appropriate use criteria (AUC) within our policies
• Develop and write new policies in collaboration with Cohere’s Clinical Content Team, for existing clinical areas and new clinical areas
• Consider provider facing website with clinical content, policies, decision tools (society AUC), etc
• Participate in annual review with the operational physicians, review current literature for recommendations
• Obtain feedback from operational physicians around P2P complaints, pain points/policy gaps
• Contribute to the content library, identify guideline level indications
• Physicians must be present at the meeting to sign off on content
• Be responsible for clinically relevant content and discussions at the MAB quarterly and annual meetings
• Assist compliance team in auditing rule functionality and effectiveness, evaluate PTAs, and audit AAs
• Follow regulatory changes/guidelines and determine any impact to Cohere’s current business model

Preferred Qualifications

• MBA or advanced degree in healthcare-related discipline
• Membership in national and/or regional specialty societies, willing to assist Cohere in partnership conversations

Benefits

• Health insurance
• 401k
• Bonus