Jobs at Cohere Health

Draft, refine, and maintain medical policy documents using current scientific evidence and CMS guidelines. Manage review processes, mentor writers, maintain policy repository, track project progress, and communicate updates to clinical leadership and stakeholders.

Lead executive relationships with large health plan clients, own strategic account plans, identify and close expansion opportunities, drive cross-functional collaboration, advocate client priorities internally, and ensure successful delivery and exceptional client outcomes.

Lead end-to-end implementations for payer and provider customers, manage cross-functional teams, partner with sales and product to scope launches, track project schedules and risks, build repeatable playbooks, and nurture customer relationships to ensure successful deployments and expansion.

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.

Lead technical design, build, and operate scalable, secure healthcare integration systems. Drive architecture, event-driven distributed systems, APIs, observability, IaC, CI/CD, incident response, cross-functional delivery, and mentor engineering 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.

Lead full‑stack engineering efforts to design, build, and operate production healthcare systems. Own epic-level features, mentor engineers, design for reliability and scalability, integrate with partners, and ensure launch readiness across backend (Java/Groovy), frontend (React/TypeScript), data (MongoDB), and event-driven pipelines (Kafka).

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

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.

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.

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.

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.

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.

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.