Cohere Health is a Software-as-a-Service (SaaS) company focused on improving the patient journey by enhancing the quality of care at lower costs, as well as emp
Medical Director Cardiovascular Medicine
Location
United States
Posted
3 days ago
Salary
$250K - $280K / year
Seniority
Senior
Job Description
Medical Director Cardiovascular Medicine
Cohere Health
Opportunity Overview: We are looking for physicians who have expertise in Cardiology and Vascular medical topics to deliver on Cohere’s Cardiology program by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. Reporting to the Managing Medical Director, Cardiovascular 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 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, ensuring a member and provider can easily reference and understand your decision - Use correct templates for documenting decisions during case review - Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research - Demonstrate the highest level of professionalism, accountability, and service in your 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 What you’ll need - 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 - you should be 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 - Consultant agrees to cooperate fully with Cohere by obtaining state licenses or registrations when requested by Cohere. Pay & Perks: 💻 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 The salary range for this position is $250,000 to $280,000 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. Interview Process*: - Connect with Talent Acquisition for a Preliminary Phone Screening - Meet your Hiring Manager! - Behavioral Interview(s) *Subject to change About Cohere Health: Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members. With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. The Coherenauts, as we call ourselves, 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. 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. #LI-Remote #BI-Remote
Related Guides
Related Categories
Related Job Pages
More Medical Director Jobs
Market Physician Executive
Monogram HealthA leading multispecialty provider of in-home, evidence-based care and benefit management services.
• Monogram Market Physician Executive (MPE) are mission driven physician leaders who are dedicated to improving the well-being, quality of life, and health outcomes for our patients • The MPE will lead our in-home multi-specialty polychronic care model in an assigned market • The MPE will collaborate with Monogram Health’s Multi-Specialty Platform to leverage employed specialists to deliver in-home specialty care • Aligning with the quadruple AIM, the MPE will focus to improve patient experience, population health outcomes, provider satisfaction and lower costs • The primary goal of each MPE to deliver exceptional outcomes through disease detection and evidence based clinical pathways and disease treatment • Reporting to the Region President, the Market Physician Executive (MPE) is a key clinical leader within Monogram Health who contributes to the development and oversight of clinical strategies, policies, programs, processes, protocols, guidelines, and operations that drive improved patient health outcomes within the market • The MPE oversees the daily clinical and business operations through delivery of direct patient care, care management services, social worker support and pharmacy services within the market
Otolaryngologist, Physician Reviewer – Field Medical Director, Radiology
EvolentEvolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture.
• Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines • Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available • Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process • Aids and acts as a resource to Initial Clinical Reviewers • Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner • May assist the Senior Medical Director in research activities/questions related to the Utilization Management process
Endocrinology Physician Reviewer – Field Medical Director, Radiology
EvolentEvolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture.
• Currently seeking Endocrinologist Physicians to join our Radiology department • As an FMD, Radiology you will be a key member of the utilization management team. • Serve as the Physician match reviewer in Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert. • Discusses determinations (peer to peer phone calls) with requesting physicians or ordering providers, when available, within the regulatory timeframe of the request and provides clinical rationale for standard and expedited appeals. • Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. • Aids and acts as a resource to Initial Clinical Reviewers. • Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner. • May assist the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. • Participates in on-going training per inter-rater reliability process.
Role Description The IQVIA Cell and Gene Therapy Center of Excellence (CAGT COE) is looking for an exceptional Board-Certified physician to join our team as a Medical Strategy Lead. This role focuses on expanding our CAGT portfolio, particularly in Gene Therapy/Gene Editing platforms, and advancing clinical development. - Drive growth of the IQVIA CAGT portfolio through scientific and clinical expertise. - Provide clinical and scientific expertise to all IQVIA divisions as requested. - Collaborate closely with indication-specific teams to develop integrated strategies for CAGT clinical trials and studies. - Engage in early business development activities, providing scientific knowledge to guide sponsors in CAGT development. - Drive thought leadership activities including presentations, publications, and interactions with the medical scientific community. Qualifications - A physician (MD or DO) or physician/scientist (MD/PhD) with experience in CAGT, especially in gene therapy/gene editing. - A degree from an accredited and internationally recognized school is required. - Certification in any medical sub-specialty will be considered; preference for candidates with formal training in Neurology, Medical Genetics, or Cardiology. - Highly qualified candidates with other terminal degrees such as a PhD or Pharm D will also be considered. - At least 5 years of clinical research relevant experience, including operational delivery and/or drug development experience in gene therapy/gene editing. - Robust and current knowledge of scientific, clinical, regulatory, commercial, and competitive landscape in CAGT. - Excellent consultation and advice skills on multiple assignments, with initiative and flexibility. - In-depth knowledge of applicable clinical research regulatory requirements (e.g., GCP and ICH guidelines). - Demonstrated ability to understand customer needs and negotiate solutions with stakeholders. - Strong clinical research skills and commitment to evidence-based and patient-centered clinical development. Requirements - Accountable for creating innovative, evidence-based, and patient-centered delivery strategies for CAGT trials or studies. - Partner with indication-specific Medical Strategy, Operations, Sales, and other functions to achieve annual Gross New Business targets. - Responsible for the inclusion of CAGT elements into proposals. - Provide scientific, clinical, and operational advice to internal stakeholders developing proposals. - Support preparation of customer and bid defense meetings. - Attend and present at customer meetings, bid defense, or partnership meetings as required. - Participate in strategic business development activities including presentations to prospective clients. - Maintain awareness of industry pipeline and scientific and business landscape. - Lead CAGT thought leadership at IQVIA, including publications and presentations. Benefits - The potential base pay range for this role is $186,300.00 - $519,000.00. - Actual base pay may vary based on job-related qualifications, location, and schedule. - Incentive plans, bonuses, and/or other forms of compensation may be offered. - Range of health and welfare benefits available. Company Description IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.



