Jobs at Cohere Health

Partner with stakeholders to gather and document data requirements, translate needs into user stories and technical specs, perform SQL-based data analysis, source-to-target mapping, and validation, support data quality, lineage, and monitoring, serve as primary requirements contact, contribute to Agile ceremonies, assist change management and rollout, and maintain operational and client documentation.

The Medical Director will lead clinical program design and strategy, collaborating with teams to improve clinical offerings and client relationships in the healthcare sector.

Manage a team in technical configuration for healthcare PaaS clients, translating requirements, testing functionalities, and troubleshooting issues.

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.

The Medical Director, Clinical Strategy leads clinical program design and strategy, collaborating cross-functionally to meet client needs and support growth initiatives.

Build and maintain scalable, governed data pipelines from ingestion through transformation and integration. Implement schema validation, data quality checks, job monitoring, and production-grade APIs. Work with Python, SQL, Airflow, dbt, AWS (EMR, Athena, S3), Iceberg/Parquet, and contribute to CI/CD, observability, and on-call support while collaborating with analytics and product teams.

Partner with sales, implementation, and product to advise payer executives on utilization management transformation. Lead consultative scoping, build business cases and ROI models, demonstrate platform value, and support enterprise sales by shaping scalable processes and cross-functional delivery for health plan partnerships.

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.

Optimize workforce performance for service and clinical operations by forecasting staffing, managing intraday operations for Intake and Clinical RN teams, monitoring productivity and queues, delivering performance reports and insights, identifying improvement and automation opportunities, leading daily operational meetings, and preparing leadership presentations.

Perform comprehensive MS-DRG and APR-DRG inpatient coding audits to validate DRG assignment and reimbursement, produce well-supported findings citing AHA Coding Clinic and ICD-10 guidelines, use DRG encoder tools to maximize overpayment identification, support provider appeals/disputes, meet quality and productivity standards, maintain HIPAA compliance, and stay current on coding and payment policy changes.

Perform evidence-based medical reviews for orthopedic spine cases, determine appropriateness of services, document decisions in workflow tools, meet turnaround times, and support operational and clinical improvement projects while communicating with team members and providers.

Design, implement, and validate data mapping, transformation, and integration solutions for payment integrity. Investigate and resolve complex data quality issues, create mapping specs and documentation, partner with stakeholders, and mentor analysts to improve data quality and automation.

Perform utilization management medical necessity reviews, draft compliant member and provider correspondence, consult with Medical Directors, ensure regulatory and accreditation compliance (NCQA/CMS), document determinations, meet productivity and turnaround goals, and support verbal notification workflows for timely clinical communication.

Physician role performing evidence-based utilization reviews and clinical determinations for medical appropriateness. Review and refine clinical decision guidelines, document decisions in workflow tools, conduct peer-to-peer discussions with treating providers, and support clinical content, operational improvements, and team efficiency. Maintain required medical credentials and comply with managed care regulatory expectations.

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.

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.

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.