Medical Director, Clinical Strategy, Sleep Medicine

Summary

Join Cohere Health as a Physician with Sleep Medicine expertise to shape the future of our clinical offerings. You will be a key driver of new program design and innovation, working closely with clients, specialty societies, and internal teams. This role demands strategic thinking, strong execution, and collaboration. You will leverage your clinical expertise and understanding of the health plan market to contribute to our growth and success. The position requires a physician leader who can think strategically and drive execution in a fast-paced environment. We value empathy, collaboration, and a commitment to our core values.

Requirements

• Completed US-based residency program in Internal Medicine, Family Medicine
• Board certification in Sleep Medicine 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 training
• 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
• 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
• Participate in our Medical Advisory Board (MAB) by attending quarterly meetings and help recruit new members as needed for new specialties
• 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
• Thought leadership, partnering with the marketing team for white papers, content ideation, webinars, specialty society meetings
• Determine provider quality/provider tracks ensuring the metrics are clinically relevant and fair, consider practice type etc., using specialty society data and criteria, and quality metrics when possible
• Partner with data science and use clinical outcomes to design predictive models to understand good and bad outcomes from procedures/surgeries to inform Cohere’s proprietary policies
• Partner with Clinical Operations & Analytics to continually improve current rules and develop advanced rules using ML models and AI capabilities
• Provide expert input on trend innovation/programs within specialty area to improve patient outcomes
• Leverage technology to streamline/ improve automation for our internal stakeholders (RN and MD) for high volume reviews (PT) to drive efficiencies
• Develop and write new policies in collaboration with Cohere’s Clinical Content Team, for existing and new clinical areas, leveraging society clinical practice guidelines (CPG) and appropriate use criteria (AUC)
• Obtain feedback from operational physicians around P2P complaints, pain points and policy gaps and review current literature for recommendations
• 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

• Sleep medicine fellowship
• 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