Jobs at Cohere Health

Consult PaaS clients on prior authorization decision automation programs, translating requirements into technical blueprints and partnering with Product, Design, Development, and Engineering. Build strategic improvement roadmaps, analyze healthcare authorization data, maintain dashboards and reports, monitor client KPIs, and ensure automation success throughout the customer lifecycle. The role also identifies scalable workflow improvements and guides customers in maximizing platform value.

Leads clinical process improvement, implementation, remediation, correspondence workflows, and cost-saving initiatives. Monitors performance against client SLAs, conducts root cause analyses, develops policies and work instructions, and ensures compliance with healthcare regulations and accreditation standards. Collaborates with clinical operations, product, and analytics teams to improve consistency, scalability, automation, and quality. The role also translates business requirements into actionable specifications and influences stakeholders across teams.

Manages clinical operations process improvement, utilization management performance, remediation plans, work instructions, regulatory compliance, and correspondence template tracking. Collaborates with clinical leadership, product, and analytics teams to reduce process variation, improve automation, meet client SLAs, and support scalable delegated-client implementations.

Configures and tests clinical platform requirements for healthcare clients, defines test scenarios and success criteria, troubleshoots technical issues, and supports implementations. Serves as a configuration subject-matter expert for client-facing teams, collaborates with Product, Development, Design, and Engineering, and helps develop scalable configuration management tools.

Leads a 20-plus-person distributed Review Engineering organization across three agile squads. Owns technical direction, production reliability, incident response, system scalability, delivery metrics, hiring, performance management, and engineering career growth. Partners with Product, Design, Security, Clinical Operations, and peer engineering teams to deliver reliable, secure, high-quality systems in a regulated healthcare environment.

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.

Designs and delivers large-scale, governed data pipelines and infrastructure across the full data lifecycle. Responsibilities include coding in Python and SQL, optimizing Airflow, dbt, AWS, Kafka, and Iceberg/Parquet workflows, implementing data quality and observability, contributing to architecture and tool evaluations, mentoring engineers, collaborating with stakeholders, and participating in on-call support.

Analyze administrative and clinical healthcare data to build reporting solutions, identify optimization opportunities, and support clinical program effectiveness. Apply statistical analysis, data mining, and predictive modeling to improve decision-making, patient outcomes, utilization, and cost efficiency. Develop dashboards and KPIs, monitor healthcare trends, collaborate with clinical, data science, engineering, and client teams, and lead complex multidisciplinary projects.

Reviews clinical information for speech-language pathology services, determines medical necessity using evidence-based guidelines, documents decisions, conducts peer-to-peer provider discussions, and supports clinical quality, operational improvement, and member/provider experience initiatives.

Reviews therapy services for medical appropriateness using evidence-based guidelines and clinical judgment. Conducts timely utilization reviews, documents medical necessity decisions, participates in peer-to-peer discussions with treating providers, and supports clinical guideline development, team expertise, operational improvements, and member/provider experience. Requires expertise in PM&R, Family Practice, Pediatrics, or Internal Medicine and knowledge of PT, OT, and SLP programs.

Reviews clinical information for musculoskeletal and orthopedic services, determines medical appropriateness using evidence-based guidelines, documents decisions, conducts peer-to-peer provider discussions, meets review turnaround and quality standards, and supports clinical expertise and operational improvement projects. The role requires a Doctor of Physical Therapy, active or eligible licensure, substantial direct patient care experience, and managed care utilization review experience.

Reviews occupational therapy clinical information to determine medical appropriateness using evidence-based guidelines. Documents determinations in workflow tools, meets review turnaround times, conducts peer-to-peer discussions with providers, explains outcomes and alternatives, and supports clinical expertise, operational improvement, and member/provider experience initiatives. The role requires an active OT license, direct patient care experience, and managed care utilization review experience.

As a Staff Software Engineer, you will enhance platform engineering by improving deployment strategies and developer experiences, establishing reliable systems and mentorship across teams.

The Associate Medical Director oversees clinical reviews for orthopedic services, ensuring evidence-based guidelines are applied and communication is effective. Responsibilities include peer discussions for clinical clarity, documentation, and supporting operational improvements, requiring extensive experience in orthopedic surgery and managed care.

This role involves reviewing clinical information, providing medical determinations in Cardiovascular Medicine, and ensuring high-quality patient outcomes through evidence-based guidelines. The Medical Director collaborates with teams to enhance clinical practices and manages operational improvements.

Build and independently deliver full-stack healthcare software features using Java or Groovy, React and TypeScript, MongoDB, and Kafka. Responsibilities include design, implementation, testing, deployment, production debugging, code reviews, design documentation, dependency coordination, process improvements, and mentoring. The role requires reliable delivery with minimal oversight and collaboration across engineering, product, and QA teams in a remote-first environment.

Supervise and develop a remote RN Reviewer team, manage daily productivity and timeliness reports, lead meetings, train new RNs, capture process improvements, and provide performance coaching to meet clinical operations metrics.

Lead clinical strategy and program design for diagnostic imaging, serve as the clinical subject-matter expert for client engagements, drive go-to-market and partnership activities, monitor program performance, and support growth through client-facing work and cross-functional collaboration.

Own end-to-end delivery of Cohere's inpatient platform for health plan clients, from contract signature through implementation, optimization, and operations. Coordinate Product, Engineering, Clinical Operations, Analytics, and Client Experience; translate client needs into product requirements; monitor performance, manage risk, drive operating cadence, and ensure measurable client value realization.

Lead end-to-end technical integrations with enterprise healthcare customers from pre-sales through production. Scope and deliver architecture, POCs, API integrations, data mappings, and runbooks. Ensure AI/ML features meet regulatory and clinical safety standards, build reusable integration patterns, collaborate cross-functionally, and mentor junior engineers to drive successful go-lives.