Medical Director – Orthopedic Surgery

🔥 3 minutes ago

🌵 Arizona, Florida, +4 more states – Remote

🌵 Arizona – Remote 🐊 Florida – Remote 🌾 North Dakota – Remote 🌲 Oregon – Remote ❄️ Minnesota – Remote 🤠 Texas – Remote

💵 $240k - $260k / 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

• Deliver Cohere’s musculoskeletal and orthopedic programs by determining the medical appropriateness of services • Review clinical information and apply evidence-based guidelines • Provide timely medical reviews meeting Cohere’s quality parameters • Make clinical determinations using evidence-based criteria and clinical acumen • Document communication and decision-making accurately in Cohere workflow tools • Use correct templates during case review • Meet turnaround times for clinical reviews • Conduct peer-to-peer discussions with treating providers to clarify information and explain review outcomes • Provide feedback on alternate treatment based on medical necessity criteria and evidence-based research • Interact professionally with Cohere teammates and providers • Support projects that build team clinical expertise and efficiency • Support operational improvements and member/provider experience involving clinical review tasks

🎯 Requirements

• Completed US-based residency program in Orthopedic Surgery • Board certification by appropriate specialty board as an MD or DO • Current unrestricted state license to practice medicine; reviewers must maintain necessary credentials to retain the position • 5+ years of clinical practice beyond residency/fellowship • 1+ years of managed care utilization review experience preferred • Membership in national and/or regional specialty societies preferred • Licensure in AZ, FL, MN, ND, OR, or TX is highly desirable • Willingness to obtain additional state licenses with Cohere's support

🏖️ 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 and health savings account • Flex Time Off + company holidays • Up to 14 weeks of paid parental leave • Pet insurance • Bonus included as part of the total benefits package • Support to obtain additional state licenses

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