Medical Director, Clinical Strategy Sleep Medicine - job 1 of 2

Company Overview:

Cohere Health is a fast-growing clinical intelligence company that’s improving lives at scale by promoting the best patient-specific care options, using cutting-edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health plans covering over 15 million lives, while our revenues and company size have quadrupled.  That growth combined with capital raises totaling $106M positions us extremely well for continued success. Our awards include: 2023 and 2024 BuiltIn Best Place to Work; Top 5 LinkedIn™ Startup; TripleTree iAward; multiple KLAS Research Points of Light awards, along with recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.

Opportunity Overview:

We’re looking for a physician who has expertise in Sleep Medicine to determine the strategy and help with the evolution of Cohere Health’s clinical offerings as strategic thinker, executor, and subject matter expert. You’ll be a fundamental driver of new clinical program design, strategy, and innovation.

Reporting to the SVP, Senior Medical Director Clinical Strategy, the ideal candidate will have a deep understanding of the health plan market and proven success in clinical, care management, or similar strategic roles supporting the successful execution of consultative engagements designing programs for current and existing clients. Most importantly, this exciting new role requires a physician leader who can think strategically and is equally strong in driving execution as we develop and launch new clinical and care management offerings. The work will be fast-paced with evolving needs, requiring flexibility, emotional intelligence, curiosity, and grace under pressure. 

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:

• Support Cohere’s clinical credibility by deepening relationships with current clients and future clients
• Develop relationships with specialty societies and secure partnerships. Attend annual society meetings and manage quarterly meetings (or more frequent) with society partners
• Participate in our Medical Advisory Board (MAB) by attending quarterly meetings and help recruit new members as needed for new specialties
• Support ad-hoc client requests with partnership of operational MDs (case review, policy questions, audits, etc)
• Support Cohere’s growth team with prospective clients, engaging with the health plans medical directors during activation phase of implementation
• Thought leadership, partnering with the marketing team for white papers, content ideation, webinars, specialty society meetings
• Determine provider quality/provider tracks ensuring the metrics are clinically relevant and fair, consider practice type etc., using specialty society data and criteria, and quality metrics when possible
• Partner with data science and use clinical outcomes to design predictive models to understand good and bad outcomes from procedures/surgeries to inform Cohere’s proprietary policies
• Partner with Clinical Operations & Analytics to continually improve current rules and develop advanced rules using ML models and AI capabilities
• Provide expert input on trend innovation/programs within specialty area to improve patient outcomes
• Leverage technology to streamline/ improve automation for our internal stakeholders (RN and MD) for high volume reviews (PT) to drive efficiencies
• Develop and write new policies in collaboration with Cohere’s Clinical Content Team, for existing and new clinical areas, leveraging society clinical practice guidelines (CPG) and appropriate use criteria (AUC)
• Obtain feedback from operational physicians around P2P complaints, pain points and policy gaps and review current literature for recommendations
• Assist compliance team in auditing rule functionality and effectiveness, evaluate PTAs, and audit AAs
• Follow regulatory changes/guidelines and determine any impact to Cohere’s current business model

Your Background and Requirements:

• Completed US-based residency program in Internal Medicine, Family Medicine
• Sleep medicine fellowship preferred
• Board certification in Sleep Medicine as an MD or DO with a current unrestricted state license to practice medicine - physicians must maintain necessary credentials to retain the position
• 5+ years of clinical practice beyond residency/fellowship training
• 5+ years experience in managed care or clinical strategy at a health plan, healthtech/solutions/services, expert consulting (partner-level), or  related payer-facing roles
• MBA or advanced degree in healthcare-related discipline preferred
• Membership in national and/or regional specialty societies, willing to assist Cohere in partnership conversations
• Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
• Excellent communication - written and spoken
• Comfortable with technology - Proficient in Google Docs / Sheets / Slides or Microsoft Word / Excel / PPT, willing and able to learn new software tools
• General understanding of AI/ML
• Detail-oriented, flexible, and able to work autonomously with little supervision
• Executive presence and ability to communicate effectively with partners / clients
• Strong leadership capabilities and ability to initiate and maintain cross-team relationships
• Able to work in a fast paced environment, make decisions quickly and manage a busy calendar that changes frequently
• Willingness to travel

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.

The salary range for this position is $250,000 to $300,000 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.

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