Clinical Policy Analyst

Employer: Cohere Health

Company Overview

Cohere Health is illuminating healthcare for patients, their doctors, and all those who are important in a patient’s healthcare experience, both in and out of the doctors office. Founded in August, 2019, we are obsessed with eliminating wasteful friction patients and doctors experience in areas that have nothing to do with health and treatment, particularly for diagnoses that require expensive procedures or medications. To that end, we build software that is expressly designed to ensure the appropriate plan of care is understood and expeditiously approved, so that patients and doctors can focus on health, rather than payment or administrative hassles.

Opportunity Overview

We are looking for a Clinical Policy Analyst who will support how this department scales and implements Medicare, Commercial, and Cohere policies within our product.

This hire will have a direct impact on the lives of our clinicians and their patients. You’ll play a central role in our policy design and implementation process by reviewing policy content and ensuring it is configured within our product to optimize the clinical review of medical services.

What you will do

• Review healthcare policy documentation and data for discrepancies and missing information and resolve discrepancies
• Support project management of policy implementation
• Enter healthcare policy data including policy text, procedure codes, and diagnosis codes into Cohere Health’s product
• Perform routine quality assurance checks
• Implement solutions that help our internal teams comply with regulations for medical services
• Prepare educational materials on updates to internal customers
• Contribute ideas on how to best organize and represent information based on internal customer and product needs

Your background and characteristics

• Tech savvy and detail oriented
• Must be knowledgeable of multiple software programs (Microsoft Word, Excel, Google Drive)
• Understanding of medical terminology, procedures, and diagnoses
• Knowledge of common disease processes, treatments, and tests
• Strong communication skills, listening effectively and asking for clarification when necessary
• Ability to work independently and as part of a team
• You are passionate about improving the U.S. healthcare system and helping ensure every patient receives the best care possible
• You are self-directed, confident, and thrive working in a fast-paced startup environment

Minimum Qualifications

• Education: Bachelor’s Degree (BA/BS) required
• Work Experience: 1-3 years of related experience working for a payer or multi-specialty provider organization, or comparable experience with a healthcare technology or managed services vendor.

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