Medical Director Therapy

Opportunity Overview: We are looking for physicians who have expertise in PM&R, Family Practice, Pediatrics, or Internal Medicine to deliver on Cohere’s program by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. Reporting to the Managing Medical Director for Cohere Health , this is a critical role in a company that is rapidly scaling to impact millions of patients. This is a fast-paced environment that favors people who are able to learn quickly, be hands-on, handle ambiguity, and communicate effectively with people of different backgrounds and perspectives. What you’ll do: Support the clinical content team in reviewing the company’s clinical decision guidelines and evidence based literature Provide expert input on content for influencing physicians in medical care to improve the quality of patient outcomes Provide timely medical reviews that meet Cohere’s stringent quality and timeliness parameters Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen and knowledge of evidence based literature and medical society guidelines Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision Use correct templates for documenting medical necessity decisions during case review Conduct timely peer-to-peer discussions with treating providers to clari