Director, Clinical Programs, Diagnostic/Cardiac Imaging - Cohere Health

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 Healthcares Fierce 15 and CB Insights Digital Health 150 lists.

Opportunity Overview:

Cohere’s Clinical Programs team is responsible for conceiving, designing, developing, and continuously refining clinical specialty programs that reduce medical expenses, reduce provider burden, and optimize care. Clinical programs utilize data and technology to shift utilization management from a transactional experience to one that drives personalized care for patients and value for those who care for them. 

Cohere’s clinical programs align patient, provider, and payer needs and ensures that the right care is delivered at the right time across a variety of orthopedic procedures and therapies.  Rapidly growing with new and existing clients, clinical programs leverage Cohere’s portfolio of interventions to influence care decisions toward clinically appropriate care.

Reporting to the Senior Director, Clinical Programs, the Director, Diagnostic/Cardiac Imaging Clinical Programs is a crucial role in our organization to optimize current offerings and develop new Programs for health plan and risk-bearing clients that achieve clinical and business goals. This is a highly cross-functional role and will work closely with Trend Innovation and Cohere cross-functional teams. The successful candidate will be skilled in balancing clinical and operational needs, deriving data-driven insights, problem solving, building internal and external relationships, and rolling up their sleeves to achieve program results.

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:

• Own the execution of program goals and continuous improvement for Diagnostic/Cardiac Imaging clinical programs aimed at managing cost trends and improving health outcomes

• Build, communicate, and routinely update the program strategic roadmap 

• Collaborate cross-functionally with Medical, Trend Innovation, Clinical Analytics, PaaS, Product, Operations, and other teams to design and execute clinical programs 

• Develop and manage relationships with external clients, clinical partners, and business partners, in collaboration with Business Development and Strategic Accounts leaders

• Establish, communicate, and be accountable for achieving goals of solutions and partnerships; monitor outcomes and lead initiatives for clinical and business optimization

• Responsibility for additional clinical specialty areas may be included in this role’s scope of responsibility as Cohere grows

Your competencies:

• Proven track record of conceiving, executing, and driving success in tech-enabled solutions with health plans, risk-bearing entities, or utilization management vendor 

• Deep expertise in Imaging solutions and competitive landscape, economic drivers, and clinical needs

• Strong ability to support and maintain internal cross-functional and external client / partner relationships to problem solve and deliver on goals

• Excellent written and verbal communication skills, including developing and delivering executive-level presentations, tailoring communication styles to internal and external audiences, and exhibiting a high level of executive presence

• Demonstrated success in leveraging data to drive strategies and solutions

• Flexible and agile working style, skilled working in remote environments, self-directed, and operates with a sense of urgency

• Process oriented, with ability to design new processes where needed for efficiency, organization, and alignment

• Strong understanding of the Medicare and commercial insurance industry, including value-based risk models

• Strong focus on continuous process improvement

Your qualifications:

• Bachelors degree required (Preferred: MPH or an advanced degree in healthcare-related discipline, MBA,, or nursing degree)

• Licensed Clinician (Preferred: Radiology Technician, RN, OT, PT, ST, PharmD, PA, NP)

• 10+ years experience in the areas of utilization management, clinical programs, and/or care management 

• 5+ years of experience leading direct reports or providing indirect leadership

• 5+ years of experience at a health plan, risk-bearing entity, or utilization management vendor leading Imaging solutions that address administrative expenses, medical expenses and patient outcomes

• Experience launching and scaling new tech-enabled healthcare products or services