Associate Medical Director, Cardiology; Case Reviewer

Opportunity Overview:

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

Reporting to the Medical Director, Cardiology for Cohere Health, this is a critical role in a company that is rapidly scaling to impact 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.

• Support the clinical development team in reviewing the company’s clinical decision guidelines and evidence based literature
• Provide expert input on content and programs for influencing physicians in cardiovascular care to improve the quality of patient outcomes
• Provide timely medical reviews that meet Cohere’s stringent quality and timeliness 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
• 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

• U.S.
  
  -based residency in Internal Medicine and fellowship in Cardiology
• Board certification (MD or DO) with an active, unrestricted state medical license; must maintain all required credentials
• 5+ years of clinical practice beyond residency/fellowship in Internal Medicine or Cardiology
• 1+ years of managed care utilization review experience desirable
• Membership in national and/or regional specialty societies
• Licensure in FL, MN, ND, or TX is highly desirable – you should be willing to obtain additional state licenses with Cohere’s support
• 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
• Consultant agrees to cooperate fully with Cohere by obtaining state licenses or registrations when requested by Cohere.

• 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
• Up to 184 hours (23 days) of PTO per year + company holidays
• Up to 14 weeks of paid parental leave
• Pet insurance
• The salary range for this position is $200,000 to $270,000 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.

• Connect with Talent Acquisition for a Preliminary Phone Screening
• Meet your Hiring Manager!
• Behavioral Interview(s)

* Subject to change

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