Medical Director – Cardiovascular Medicine

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $250k - $280k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

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Cohere Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Cohere Health is a company focused on transforming the prior authorization process in healthcare using advanced technologies. The company offers the Cohere Unify™ Platform, which includes artificial intelligence and machine learning capabilities to improve utilization management (UM) and facilitate quicker access to patient care. By digitizing the prior authorization process and integrating with electronic medical records, Cohere Health aims to enhance the quality of healthcare outcomes and reduce the administrative burden on providers. Their solutions help decrease denial rates and adverse outcomes through evidence-based intelligence and real-time clinical suggestions. Cohere Health's offerings are available as Platform as a Service (PaaS) or as fully outsourced solutions.

📋 Description

• Determine the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines • Support the clinical development team in reviewing clinical decision guidelines and evidence-based literature • Provide expert input on content and programs influencing physicians in cardiovascular care to improve patient outcomes • Provide timely medical reviews meeting quality and timeliness parameters • Make clinical determinations using evidence-based criteria and clinical acumen • Accurately document communications and decision-making in Cohere workflow tools • Use correct templates when documenting case-review decisions • Conduct peer-to-peer discussions with treating providers to clarify clinical information and explain review outcomes • Provide feedback on alternate treatment based on medical necessity criteria and evidence-based research • Demonstrate professionalism, accountability, and service in interactions with teammates and providers • Support projects that build the team's clinical expertise and efficiency • Support operational improvements and member/provider experience involving clinical review tasks

🎯 Requirements

• U.S.-based residency in Internal Medicine and fellowship in Cardiology • Board certification (MD or DO) with an active, unrestricted state medical license; must maintain all required credentials • 5+ years of clinical practice beyond residency/fellowship in Internal Medicine or Cardiology • Membership in national and/or regional specialty societies • Willingness to obtain additional state licenses with Cohere's support • Ability to multitask and manage tasks to completion on a timely basis and in an organized fashion • Ability to excel in a matrix organization • Excellent written and spoken communication • Comfort with technology and willingness to learn new software tools • Understanding of managed care regulatory structure and processes • Detail-oriented, flexible, and able to work autonomously with little supervision • Agreement to cooperate fully with Cohere by obtaining state licenses or registrations when requested • 1+ years of managed care utilization review experience desirable • Licensure in FL, MN, ND, or TX highly desirable

🏖️ Benefits

• Fully remote opportunity with about 5% travel • Medical, dental, vision, life, disability insurance, and Employee Assistance Program • 401K retirement plan with company match • Flexible spending account and health savings account • Flex Time Off and company holidays • Up to 14 weeks of paid parental leave • Pet insurance • Bonus included in total benefits package

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