Clinical Informatics Lead, Trend Innovation

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:

This is an excellent opportunity for an outstanding clinical informaticist to join a Series B digital health company. You will work closely with clinical and analytics leadership, subject matter experts, product, data science and engineering to support trend innovation and advanced automated decision-making capabilities. The work will be fast-paced and project-based, with evolving needs - requiring adaptability, curiosity, and grace under pressure.  Your work will support the expression of clinical policies, programs, and guidelines through rules that power our products and 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’ll do:

• Monitor and analyze clinical policies and guidelines to identify opportunities to drive more appropriate, cost-effective care
• Perform literature searches, review quality measurement organization portfolios, and monitor industry news on an ongoing basis to detect healthcare trends, key drivers and root causes, and ideas for innovative interventions 
• Track policy and legislative initiatives at the state and national level to assess impact on healthcare utilization, cost, quality, and the patient/provider experience
• Collaborate with clinical SMEs and operations specialists to identify observation-driven trend opportunities 
• Utilize clinical and operations expertise to guide data scientists in surfacing meaningful data-driven insights through benchmarking, trend analysis, low value care detection, and patient/provider analytics
• Assist actuarial team with building models to estimate and validate savings projections
• Define additional objectives, key results, and early indicators
• Create reports and clearly communicate findings and prioritized recommendations to key stakeholders  
• Partner with Clinical Programs and Product teams to design forward-thinking pilot programs to impact validated opportunities

Your background & requirements:

• Master’s degree or higher in a healthcare-related field (nursing, health services research, public health, HEOR, clinical informatics) 
• 5+ years of experience working for a payer or multi-specialty provider organization, or comparable experience with a healthcare technology or managed services vendor
• Experience with evidence-based care guidelines (i.e., MCG, InterQual)
• Expertise in medical coding and standardized clinical terminologies (e.g., ICD-10, CPT, HCPCS, LOINC, SNOMED)
• Experience constructing complex rule logic and code sets utilizing claims and EHR data
• Working knowledge of data science and machine learning methods
• Exceptional communication skills and a keen ability for translating technical requirements to a less technical audience
• Analytical thinker with superior problem-solving skills and attention to detail 
• Ability to thrive in fast-paced start-up environment
• Ability to work both collaboratively and independently in a remote work environment with minimal supervision
• Avid learner with adaptable knowledge base to accommodate frequent changes in clinical guidelines and data requirements
• Experience with quality measures (e.g., HEDIS, MIPS, IQR, NQF) and care management is a plus

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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