Cohere Health

Medical Director

• Support the clinical content team in reviewing clinical decision guidelines and evidence-based literature
• Provide expert input on content intended to influence physicians and improve patient outcomes
• Provide timely medical reviews meeting quality and timeliness parameters
• Make clinical determinations using evidence-based criteria, clinical acumen, medical literature, and medical society guidelines
• Clearly document communications and decision-making in Cohere workflow tools
• Use correct templates for documenting medical necessity decisions during case review
• Conduct peer-to-peer discussions with treating providers to clarify clinical information and explain review outcomes
• Provide feedback on alternate treatment based on medical necessity criteria and evidence-based research
• Maintain professionalism, accountability, and service in interactions with teammates and providers
• Support projects that build team clinical expertise and efficiency
• Support operational improvements and member/provider experience related to clinical review tasks

Medical Director – Therapy