Director, Analytics & Insights - 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 leading edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health insurance plans covering over 15 million people, 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, along with recognition on Fierce Healthcares Fierce 15 and CB Insights Digital Health 150 lists.

Opportunity Overview:

This is an excellent opportunity for an outstanding analytics leader. You will lead a team of data analysts and clinical informatics leads, and you will work closely with clinicians, clinical program leaders, data scientists, and actuaries to support data-driven clinical programs with ownership from pilot design and opportunity sizing, through monitoring, reporting, and evaluation. This team’s primary focus around trend monitoring and program analytics, will enable the overall efficacy and continuous enhancement of clinical programs that improve a) payor/provider/patient collaboration through the utilization management and care management process, b) quality of care and patient outcomes, and c) healthcare utilization and spending efficiency.  

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:

• Deeply understand Cohere’s clinical content, products, services and clinical programs and how Cohere’s solutions intersect with healthcare providers’ workflow and patients’ care journey. 

• Direct a team of data analysts and clinical informatics leads, ensuring high collaboration with clinicians, program leaders, data scientists, and actuaries to deliver insights for data-driven clinical programs.

• Oversee key performance indicators (KPIs) for the team, manage task pipelines, and ensure timelines are met.

Key Responsibilities:

• Maintain high clinical analytics standards and develop methodologies, and processes to ensure quality control, documentation, and productization in support of clinical programs. This includes:

o Identifying, prioritizing, and evaluating program opportunities using both qualitative and quantitative methods to enhance financial trends, care quality, and patient experience.

o Defining target populations for analysis, along with outcome and success metrics.

o Ongoing evaluation of claims trends and clinical program pilots to uncover insights and refine future initiatives.

o Ensuring data integrity, accuracy and security in all analytics processes.

• Provide technical and subject matter expertise on healthcare data analysis, including medical claims, pharmacy data, and eligibility data.

• Represent the team’s work and insights to both internal and external stakeholders, effectively communicating complex technical analyses to diverse audiences.

• Guide the professional and technical growth of your team through regular feedback, KPI tracking, and personalized development plans.

• Collaborate closely with clinicians, data scientists, and program leaders to provide actionable insights that shape clinical programs and improve patient outcomes.

Your background and requirements:

• Minimum 6 years of professional experience in healthcare industry (payer, provider, consulting), with demonstrated quantitative analytical and critical thinking skills

• Minimum of 3 years in a managerial role

• Extensive knowledge of healthcare data, including medical claims, pharmacy claims, prior authorization and member eligibility data.

• Demonstrated passion for improving the U.S. healthcare system and ensuring that every patient receives the highest quality care possible.

• Proven ability to work independently and thrive in a dynamic, fast-paced start-up environment, leading cross-functional teams to meet tight deadlines.

• Exceptional communication skills, with the ability to present complex data insights to non-technical stakeholders.

• Advanced expertise in clinical terminologies such as ICD-10, CPT, HCPCS, LOINC, SNOMED, and NDC.

• Familiarity with quality measures (HEDIS, MIPS, IQR, NQF) and care management processes is a plus.

• Expertise in statistical analysis and methodologies, including hypothesis testing, regression analysis, and multivariate analysis.

• Proficiency in programming languages such as Python, R, or SAS for data analysis, automation, and model development.  

• Master’s Degree in Public Health, Health Policy, Biostatistics, or Health Economics preferred.  

We can’t wait to learn more about you and meet you at Cohere Health!