Medical Director Cardiovascular Medicine
You will bring your expertise in Cardiology and Vascular medicine to help determine the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. Reporting to the Managing Medical Director, Cardiovascular, you'll play a critical role in a rapidly scaling company impacting millions of patients. You'll need to learn quickly, be hands-on, handle ambiguity, and communicate effectively with people of different backgrounds and perspectives while delivering timely, high-quality medical reviews.
Responsibilities
- Support the clinical development team in reviewing the company's clinical decision guidelines and evidence based literature
- Provide expert input on content and programs for influencing physicians in cardiovascular 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
- Clearly and accurately document all communication and decision-making in Cohere workflow tools
- Use correct templates for documenting decisions during case review
- Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and explain review outcome decisions
- Demonstrate professionalism, accountability, and service in interactions with Cohere teammates and providers
- Support projects specific to building the team's clinical expertise and efficiency, as delegated
- Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated
Requirements
- U.S.-based residency in Internal Medicine and fellowship in Cardiology
- Board certification (MD or DO) with an active, unrestricted state medical license; must maintain all required credentials
- 5+ years of clinical practice beyond residency/fellowship in Internal Medicine or Cardiology
- 1+ years of managed care utilization review experience desirable
- Membership in national and/or regional specialty societies
- Licensure in FL, MN, ND, or TX is highly desirable - willing to obtain additional state licenses with Cohere's support
- Able to multitask and manage tasks to completion on a timely basis and in an organized fashion
- Excels in a matrix organization
- Excellent communication - written and spoken
- Comfortable with technology - willing and able to learn new software tools
- Understanding of managed care regulatory structure and processes
- Detail-oriented, flexible, and able to work autonomously with little supervision
- Agrees to cooperate fully with Cohere by obtaining state licenses or registrations when requested
Benefits
- Fully remote opportunity with about 5% travel
- Medical, dental, vision, life, disability insurance, and Employee Assistance Program
- 401K retirement plan with company match; flexible spending and health savings account
- Flex Time Off + company holidays
- Up to 14 weeks of paid parental leave
- Pet insurance