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Cohere Health

Senior Payment Strategy Manager

Posted An Hour Ago
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Remote
Hiring Remotely in United States
140K-160K Annually
Senior level
Easy Apply
Remote
Hiring Remotely in United States
140K-160K Annually
Senior level
The Senior Payment Strategy Manager will drive payment integrity strategies for healthcare clients, aligning sales and operational teams to develop business cases, execute proposals, and enhance client engagement while leveraging technology-driven solutions.
The summary above was generated by AI

Opportunity Overview:

Cohere is looking for an experienced payment integrity strategist to join our payment solutions team as we seek to expand to new payer clients. You will be a key member of the growth function, leading the process to help prospects develop the strategy and business case for PI transformation.

You will be charged with quickly developing a deep understanding of our customers’ needs and Cohere’s market-leading platform, which includes reimbursement, clinical and technology aspects. You will apply this understanding, together with your creative problem-solving and analytical skills, to support the sales function by developing compelling business cases for complex enterprise software partnerships. Your role as the glue between Cohere’s commercial and operational functions (e.g., product, payment solutions, operations, sales, etc.) will ensure that customer needs/requirements are translated seamlessly to proposals, statements of work, and to the teams charged with implementation.  

If you are passionate about deploying innovative data and technology-driven solutions to drive payment accuracy, clinical excellence, and achieve healthcare operational efficiencies, we want to hear from you. 

What you will do:

  • Become an expert on market and technology trends impacting payment integrity and related claim adjudication functions within health plans (e.g., utilization management, value-based care, interoperability, etc.)
  • Engage with payer executives as a thought partner, advising them on market trends, best practices, and opportunities to drive more business value from their PI function
  • Serve as a Cohere SME on sales calls with payer executives, capable of leading demonstrations and speaking to the value and differentiation of the Cohere platform
  • Lead consultative process to help prospects develop the strategy and business case for PI transformation:
    • Collaborate with sales executives and prospects to understand prospective customers’ business, adjudication, technical, and compliance needs
    • Collaborate with product, selections, operations, and integrations team
      to recommend Cohere solutions for the client’s needs
    • Collaborate with selections team to quantify savings for prospective clients
    • Prepare executive presentations for prospective customers
    • Project manage cross-functional proposal / pricing process
    • Ensure client buy-in and internal sign-off on proposal documents
    • Draft statements of work to appropriately reflect client requirements and Cohere capabilities 
    • Partner with solution architecture and implementation teams to ensure requirements translate into build plan
  • Apply expertise to develop thought leadership content that helps clients shape their PI transformation agendas
  • Contribute to growth function by identifying opportunities to improve our internal processes and deliverables to build a scalable and high impact sales model

What you’ll need:

Your background & Requirements:

  • Bachelor's degree.  Graduate degree in relevant field (e.g., MBA, MPH, etc.) preferred
  • 7+ years of experience in similar role for a payment integrity vendor, health-tech company, healthcare consulting, or health plan
  • Deep experience selling into, or working with, health insurance plans across different lines of business
  • Strong understanding of healthcare revenue cycle, claims reimbursement, and payment integrity
  • Understanding of health plan technology systems and workflows
    (e.g., core claims platforms, contract systems, claims data, analytics, etc.)
  • Understanding of claims processing, ICD-10 Coding, and CPT/HCPCS coding
  • Exceptional verbal and written communications skills
  • Demonstrated problem-solving and analytical ability. Experience with financial analysis and return on investment modeling
  • Customer-orientation and start-up ready mindset; comfortable with ambiguity
  • Highly collaborative and experience participating in team-led sales models 
  • Experience working with cross-functional teams; project management experience a plus
  • Willing to travel to prospect meetings

Pay & Perks:

💻 Fully remote opportunity with about 15% travel

🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program 

📈 401K retirement plan with company match; flexible spending and health savings account 

🏝️ Flex Time Off + company holidays

👶 Up to 14 weeks of paid parental leave 

🐶 Pet insurance  

The salary range for this position is $140,000 to $160,000 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.

Interview Process*:

  1. Connect with Talent Acquisition for a Preliminary Phone Screening
  2. Meet your Hiring Manager!
  3. Case Study
  4. Behavioral Interviews

*Subject to change

About Cohere Health:

Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members.

With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.

Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes.

The Coherenauts, as we call ourselves, 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.

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.


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Top Skills

Claims Data
Data Analysis
Financial Analysis
Healthcare Revenue Cycle
Healthcare Technology Systems
Payment Integrity
HQ

Cohere Health Boston, Massachusetts, USA Office

Boston, MA, United States, 02114

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