Clinical Program Director - Remote

Overview

The Clinical Program Director at Cohere Health will define the clinical strategy for the inpatient solution, leveraging AI and clinical expertise to enhance utilization management and reduce operational burdens.

In Short

• Monitor utilization trends and identify clinical drivers of unnecessary inpatient admissions.
• Design targeted programs to improve medical necessity decision-making.
• Define and evolve the clinical framework for the product.
• Translate clinical and regulatory requirements for analytics and product teams.
• Identify and track meaningful KPIs for actionable insights.
• Act as a subject matter expert in strategic conversations.
• Collaborate with client leaders for solution implementation.
• Maintain knowledge of inpatient care trends and payer strategies.

Requirements

• 10+ years of experience in inpatient utilization management.
• Clinical degree preferred but not required.
• Proven track record in designing clinical programs.
• Strong knowledge of regulatory requirements and clinical guidelines.
• Experience in cross-functional team collaboration.
• Adept at interpreting complex data and identifying trends.
• Excellent communication skills.
• Ability to thrive in a fast-paced startup environment.
• Entrepreneurial mindset focused on improvement.
• Passion for AI in utilization management.

Benefits

• Health insurance.
• 401k plan.
• Bonus opportunities.