Jobs at Cohere Health

Lead clinical informatics efforts to translate workflows into structured data, design and validate digital health solutions, oversee ontology mapping and terminology management (SNOMED, ICD, LOINC, RxNorm), ensure annotation and data quality for AI/LLM tools, and mentor junior informaticians to improve validation and workflows.

Lead technical analysis and design of healthcare interoperability solutions, defining data exchanges and integration workflows (APIs, HL7, X12, SFTP). Conduct client discovery, produce mappings and interface specs, investigate failures, develop tests, manage multiple implementations, support launches and steady-state operations, and mentor junior analysts.

Serve as a physician leader driving clinical program design and strategy for payer-facing digital care management. Advise growth and product teams, develop research and partnerships, monitor program performance, support utilization management and client engagements, and travel (~25%) for prospective client meetings to expand and optimize offerings.

Serve as the Speech-Language Pathology subject-matter expert to design and scale clinical and digital care management programs, support go-to-market and client engagements, cultivate partnerships, guide utilization and medical policy, monitor program performance, and collaborate cross-functionally. Part-time contractor (~20 hrs/week), remote with ~25% travel.

The RN Reviewer performs medical necessity reviews, collaborates with providers, documents accurately, and identifies opportunities for improvement in healthcare delivery.

Provide commercial contracting support by drafting, reviewing, and negotiating high-volume customer and vendor agreements (SaaS, MSAs, SOWs, NDAs, BAAs). Advise Sales and cross-functional teams, manage routine to moderately complex negotiations, maintain templates and playbooks, and support data privacy and AI-related contractual issues.

The Compliance Reporting Program Manager will coordinate compliance and regulatory reporting initiatives, manage workflows, and drive cross-functional collaboration for accurate and timely reporting.

Lead Engineer responsible for end-to-end feature design, development, testing, and delivery of a cloud-based healthcare platform. Work full stack from database to frontend, design scalable data services and APIs, mentor junior engineers, ensure testing and security best practices, and deploy to modern cloud infrastructure.

Lead and mentor a client-facing analyst team to design, implement, and scale prior-authorization decision automation for PaaS clients. Consult on strategic roadmaps, translate client requirements into technical blueprints, collaborate with product and engineering, optimize processes and analytics frameworks, build visualization reports from authorization and claims data, and ensure client KPIs and end-to-end automation success across the customer lifecycle.

Lead client-facing engagements to design, implement, and optimize prior-authorization decision automation for PaaS customers. Translate client needs into technical blueprints, collaborate with product and engineering, build dashboards and analyze authorization data, track KPIs, and drive continuous improvement and scale across the customer lifecycle.

Provide evidence-based medical utilization reviews for orthopedic spine cases, document decisions in Cohere workflows, conduct peer-to-peer provider discussions, meet turnaround and quality standards, and support clinical and operational improvement projects.

As a Healthcare Analyst II, you will analyze healthcare data to optimize strategies, conduct quantitative analysis, and provide insights for clinical interventions, partnering with cross-functional teams.

The Strategic Medical Director leads clinical program design and strategy, collaborates with clients and cross-functional teams for effective care delivery, and monitors clinical performance.

Operate and maintain AWS-hosted MERN applications and large-scale data workflows. Manage serverless and Spark-based pipelines, perform incident response and on-call duties, engineer automation to eliminate operational toil, ensure HIPAA/SOC2/HITRUST compliance, build observability and lead blameless post-mortems.

The Payment Selections Manager leads the identification and recovery of improper claim payments, collaborates with cross-functional teams, and improves payment integrity processes while conducting data analysis and audits.

Configure and maintain medical coverage policies in the company platform, perform QA and testing of policy configurations, monitor updates for compliance, support internal and external stakeholders, and collaborate cross-functionally to optimize policy implementation and usability.

Write and edit patient-facing adverse determination communications, translating clinical and policy content into plain, patient-centered language. Ensure regulatory compliance (CMS, NCQA, URAC, state mandates), maintain tone and readability standards, develop templates and style guides, and collaborate with clinicians, policy, informatics, and design teams to structure and automate clinical knowledge.

Perform evidence-based utilization management reviews, prepare compliant member and provider correspondence, consult with Medical Directors, document clinical determinations, ensure NCQA/CMS regulatory compliance, meet productivity and turnaround targets, support verbal notifications, and drive process improvements.

Lead and grow a distributed engineering team to build and scale AI platforms and agents for healthcare. Own technical strategy, data/retrieval/semantic architectures, ML model serving and MLOps, and deliver HIPAA-compliant, cloud-native systems in partnership with Product, Data Science, and Clinical teams.

As a Claims Auditor, you will conduct MS-DRG and APR-DRG coding reviews, ensuring the accuracy of claims to maximize overpayment identification while adhering to coding guidelines and compliance regulations.