Medical Director – Spine Surgery

🔥 15 minutes ago

🐻 Alaska, Arizona, +11 more states – Remote

🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🌺 Hawaii – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🎸 Mississippi – Remote 🤠 Texas – Remote ☕ Washington – Remote

💵 $260k - $280k / year

⏰ Full Time

🔴 Lead

👨‍⚕️ Medical Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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 • Provide timely medical reviews meeting Cohere's quality parameters • Make clinical determinations using evidence-based criteria and clinical acumen • Document communication and decision-making in Cohere workflow tools • Use correct templates during case review • Meet appropriate 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 • Maintain 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

• Completed US-based residency program in Orthopedic or Neurosurgery Surgery and fellowship program in Spine Surgery • Board certification as an MD or DO with a 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 • Membership in national and/or regional specialty societies • Licensure in AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable • Willingness to obtain additional state licenses with Cohere's support • Role is not eligible for hire in AK, CA, CO, HI, NY, or WA

🏖️ 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 in the total benefits package

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