Senior Inpatient Clinical Research Specialist

Posted 2 Days Ago
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Hiring Remotely in United States
Remote
Senior level
Healthtech • Software
Cohere Health provides intelligent prior authorization as a springboard to better quality care and outcomes.
The Role
The Senior Inpatient Clinical Research Specialist will review inpatient authorizations, synthesize patterns, design algorithms, build ML models, and consult on product design.
Summary Generated by Built In

Company Overview:

Cohere Health is a fast-growing clinical intelligence company that’s improving lives at scale by promoting the best patient-specific care options, using cutting-edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health plans covering over 15 million lives, while our revenues and company size have quadrupled.  That growth combined with capital raises totaling $106M positions us extremely well for continued success. Our awards include: 2023 and 2024 BuiltIn Best Place to Work; Top 5 LinkedIn™ Startup; TripleTree iAward; multiple KLAS Research Points of Light awards, along with recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.

Opportunity Overview:

Working on a small, fast-paced team, and reporting into the Director of Commercial Strategy, you will play a foundational role in the development and delivery of an Cohere’s inpatient product, which combines deep clinical expertise and cutting edge AI to improve clinical review accuracy and efficiency for inpatient admission authorizations. You will apply your clinical expertise to review historical cases and synthesize review patterns as a key input to automation build.

Last but not least: People 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.

What you will do:

  • Review historical inpatient admission authorizations
  • Synthesize patterns across reviews
  • Help design algorithms for evaluating inpatient admission medical necessity
  • Help build ML models that read clinical notes
  • Consult on review automation product design

Your background & requirements:

  • Registered Nurse (RN), associate or bachelor’s degree
  • 10+ years of experience conducting payer UM reviews for acute inpatient authorizations
  • 3+ years of experience in acute care hospital setting as a bedside nurse
  • Clinical Rigor: Consistently performs high quality reviews, demonstrating strong command of complex cases 
  • Operational Expertise: Deep understanding of payer end-to-end inpatient UM workflows, regulatory requirements (e.g., CMS 2MN Rule), and guidelines (i.e., MCG, IQ)
  • Analytical: Ability to identify patterns across reviews, summarize in a report, and generate actionable data-driven recommendations
  • Communication: Proactive, comprehensive, clear, and concise (a)synchronous communication
  • Technology Use: Proficient in key technology applications (e.g., MacBook, Slack, Google Suite, UM review tools)
  • Leadership: Go-to resource for peers on best practices, and drives continuous improvement across the UM team
  • Ownership: Takes ownership of work and is a self-starter
  • Agility: Comfort operating in a fast-paced startup environment
  • Perspective on AI: Passion for and conceptual understanding of how AI can be used to optimize UM
  • Entrepreneurial: Natural inclination to look for ways to improve the status quo

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.

The salary range for this position is $75,000 to $85,000 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.

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The Company
HQ: Boston, MA
800 Employees
Remote Workplace
Year Founded: 2019

What We Do

Cohere Health is a clinical intelligence company that provides intelligent prior authorization as a springboard to better quality outcomes by aligning physicians and health plans on evidence-based care paths for the patient's entire care journey. Cohere's intelligent prior authorization solutions reduce administrative expenses while improving patient outcomes. The company is a Top 5 LinkedIn™ Startup, winner of the TripleTree iAward, consecutive KLAS Research’s Points of Light recipient, and has been named to Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.

Why Work With Us

Cohere Health brings together a community of healthcare and technology team members, passionate about changing the challenging parts of healthcare. If you enjoy solving challenging problems and learning about healthcare, then Cohere Health is a great career choice.

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Cohere Health Offices

Remote Workspace

Employees work remotely.

Cohere employees work from 48 different states throughout the US - Cohere hosts retreats at the Boston office in the North End.

Typical time on-site: None
HQBoston, MA
A great location in the North End Boston.

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