Medical Director Utilization Management
About the role
We are seeking a Medical Director for Utilization Management to join our dynamic team. The ideal candidate will have expertise in Internal Medicine and will play a crucial role in improving patient outcomes through clinical reviews and decision-making.
Responsibilities
- Support the clinical content team in reviewing and updating clinical decision guidelines and evidence-based literature
- Provide expert input on medical care guidelines to influence physicians
- Conduct timely medical reviews meeting Cohere’s quality and time parameters
- Document all communication and decisions in Cohere workflow tools
- Engage in timely peer-to-peer discussions with treating providers to clarify clinical information and explain review outcomes
- Ensure high levels of professionalism, accountability, and service in interactions with Cohere teammates and providers
- Participate in projects to enhance team clinical expertise and operational efficiencies
Requirements
- Completed US-based residency program and fellowship in Internal Medicine
- Board certified MD or DO with a current unrestricted state license to practice medicine
- 5+ years of clinical practice beyond residency/fellowship in Internal Medicine
- Experience in managed care utilization review is desirable
- Licensure in AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable
Qualifications
- Comfortable with technology and willing to learn new software tools
- Understanding of managed care regulatory structure and processes
- Detail-oriented, flexible, and able to work independently
- Membership in national and/or regional specialty societies preferred
Benefits
The company offers a comprehensive benefits package including medical, dental, vision, life, disability insurance, an Employee Assistance Program, a 401(k) retirement plan with company match, and flexible spending and health savings accounts. Additionally, there is up to 14 weeks of paid parental leave, pet insurance, and a fully remote opportunity with about 10% travel.
Pay & Perks
The salary range for this position is $240,000 to $250,000 annually. The company also provides a flexible work schedule, company holidays, and a variety of perks including a wellness program and professional development opportunities.
Interview Process
- Connect with Talent Acquisition for a preliminary phone screening
- Meet your Hiring Manager
- Behavioral interview(s)
About Cohere Health
Cohere Health’s clinical intelligence platform and AI-powered solutions optimize the speed, cost, and quality of care. Our Payment Integrity Suite, anchored by Cohere Validate™, helps reduce waste, improve collaboration, and ensure timely and accurate payments. We are committed to fostering an inclusive environment and are backed by leading investors.
Equal Opportunity Statement
Cohere Health is an Equal Opportunity Employer. We strive to create a welcoming and supportive workplace for all employees.