Associate, Clinical Policy Specialist

Company Overview

Cohere Health is a fast-growing clinical intelligence company that’s improving lives at scale by promoting the best patient-specific care options, using cutting-edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health plans covering over 15 million lives, while our revenues and company size have quadrupled.  That growth combined with capital raises totaling $106M positions us extremely well for continued success. Our awards include: 2023 and 2024 BuiltIn Best Place to Work; Top 5 LinkedIn™ Startup; TripleTree iAward; multiple KLAS Research Points of Light awards, along with recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.

Opportunity overview

We are looking for an Associate, Clinical Policy Specialist who will support how this department scalably implements Medicare, Commercial, and Cohere policies within our product.

This hire will have a direct impact on the lives of our clinicians and their patients. You’ll play a central role in our policy design and implementation process by reviewing policy content and ensuring it is configured within our product to optimize the clinical review of medical services. 

Last but not least: People who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.

What you will do

• Review healthcare policy documentation and data for discrepancies and missing information and resolve discrepancies 
• Enter healthcare policy data including policy text, procedure codes, and diagnosis codes into Cohere Health’s product 
• Perform routine quality assurance checks
• Implement solutions that help our internal teams comply with regulations for medical services
• Prepare educational materials on updates to internal customers
• Contribute ideas on how to best organize and represent information based on internal customer and product needs 

Your background and characteristics

• Tech savvy and detail oriented 
• Must be knowledgeable of multiple software programs (Microsoft Word, Excel, Google Drive)
• Understanding of medical terminology, procedures, and diagnoses
• Knowledge of common disease processes, treatments, and tests 
• Strong communication skills, listening effectively and asking for clarification when necessary
• Ability to work independently and as part of a team
• You are passionate about improving the U.S. healthcare system and helping ensure every patient receives the best care possible
• You are self-directed, confident, and thrive working in a fast-paced startup environment

Minimum Qualifications

• Education: Bachelor's Degree (BA/BS) required;
• Work Experience: 6 months of related experience working for a payer or multi-specialty provider organization, or comparable experience with a healthcare technology or managed services vendor.

We can’t wait to learn more about you and meet you at Cohere Health!

Equal Opportunity Statement: 

Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all.  To us, it’s personal.

The salary range for this position is $50,000 to $60,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

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