Correspondence and Clinical Process Manager

8 hours, 16 minutes ago
Full-time
Mid Level
Project and Program Management
Cohere Health

Cohere Health

Cohere Health transforms healthcare utilization management and prior authorization, aligning physicians and health plans for better patient outcomes and reduced costs.

Insurance
251-1K
Founded 2019
$56M raised

Description

  • Support clinical process improvement and new delegated client initiatives.
  • Monitor performance against client service-level agreements and influence operational results.
  • Conduct root cause analyses and support remediation plans, including corrective action plans.
  • Collaborate with product and analytics teams to improve clinical operations.
  • Assess clinical operations against work instructions, policies, and procedures.
  • Develop and update work instructions.
  • Ensure processes comply with healthcare regulations and accreditation requirements.
  • Optimize the correspondence and letters process, including template tracking.

Requirements

  • Bachelor’s degree in healthcare and active clinical licensure in the state of residence; RN, PT, OT, or SLP considered.
  • 3+ years of experience in utilization management operations.
  • Working knowledge of CMS, Medicaid, and JCAHO regulations and accreditation requirements.
  • Proficiency with Excel or Google Sheets for data analysis and quantitative decision-making.
  • Comfort building presentations in PowerPoint or Google Slides.
  • Hands-on process improvement experience; policy, procedure, or work-instruction development preferred.
  • Strong communication, stakeholder management, and influencing skills, including the ability to influence without direct authority.
  • Experience in healthcare operations, payer/provider communications, or utilization management leadership preferred.
  • Experience with automation technologies and workflow platforms; AI/ML exposure in utilization management preferred.
  • Lean Six Sigma certification, change management experience, or experience translating operational needs into business requirements preferred.

Benefits

  • Fully remote work opportunity with approximately 10% travel.
  • $110,000–$123,000 annual salary, plus bonus and benefits.
  • Medical, dental, vision, life, disability insurance, and Employee Assistance Program.
  • 401(k) retirement plan with company match, flexible spending account, and health savings account.
  • Flexible time off and company holidays.
  • Up to 14 weeks of paid parental leave.
  • Pet insurance.

Interested in this position?

Apply directly on the company website

Apply Now

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