Medical Reviewer, Physician Assistant
About the role
We are looking for an orthopedic spine Physician Assistant to help deliver on Cohere’s musculoskeletal and orthopedic programs by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. The physician assistant should have previous experience in managing spine conditions in an office setting as well as assisting on spine cases in the operating room.
Responsibilities
- 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
- Maintain appropriate turn-around times for clinical reviews
- 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
- Clearly communicate with team members
Requirements
- Graduate of an accredited Physician Assistant program
- Current NCCPA certification (PA-C) and active, unrestricted Physician Assistant license in at least one U.S. state
- 3+ years of clinical experience supporting orthopedic spine surgeons and/or neurosurgeons treating spine conditions
- Utilization management, prior authorization, or medical review experience a plus
- Membership in organizations such as the AAPA or specialty spine organizations
Qualifications
This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events.
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
Pay & Perks
The salary range for this position is $120,000 to $135,000 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.
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 agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
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.