Associate Medical Director, Pain Management

Company Overview:

Cohere Health is illuminating healthcare for patients, their doctors, and all those who are important in a patient’s healthcare experience, both in and out of the doctors office.  Founded in August, 2019, we are obsessed with eliminating wasteful friction patients and doctors experience in areas that have nothing to do with health and treatment, particularly for diagnoses that require expensive procedures or medications.  To that end, we build software that is expressly designed to ensure the appropriate plan of care is understood and expeditiously approved, so that patients and doctors can focus on health, rather than payment or administrative hassles. 

Opportunity Overview:

We are looking for physicians who have expertise in Pain Management to deliver on Cohere’s musculoskeletal program by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. 

Reporting to the Senior Medical Director for Cohere Health, and part of the review team that includes non-clinical intake specialists and nurses, this is a critical role in a company that is rapidly scaling, impacting millions of patients. This is a fast-paced environment that favors people who are able to learn quickly, be hands-on, handle ambiguity, and communicate effectively with people of different backgrounds and perspectives.

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:

• Provide timely medical reviews that meet Cohere’s stringent quality parameters
• Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen
• Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision
• Use correct templates for documenting decisions during case review
• Meet the appropriate turn-around times for clinical reviews
• Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research
• Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
• Support projects specific to building the team's clinical expertise and efficiency, as delegated
• Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated

Your Background and Requirements:

Required:

• Completed US-based residency program in Pain Management
• 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 in Pain Management, fellowship in Pain Management.

Preferred:

• 1+ years of managed care utilization review experience
• Membership in national and/or regional specialty societies
• Licensure in GA or TX is highly desirable - you should be willing to obtain additional state licenses with Cohere's support

Competencies/Success Factors:

• Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
• Excels in a matrix organization
• Excellent communication - written and spoken
• Comfortable with technology - willing and able to learn new software tools
• Understanding of managed care regulatory structure and processes
• Detail-oriented, flexible, and able to work autonomously with little supervision

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.

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