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← Cohere Health

Clinical Integrity Manager

Cohere Health
Location
United States
Posted
12 days ago
Department
Strategic Operations
Salary
$108,000 to $125,000
What they actually want (must-haves)
  • An RN, PT, OT, or SLP with an active, unrestricted clinical license
  • Bachelor's degree in Nursing, Therapy, Healthcare Administration, or a related field
  • 5+ years of progressive experience in Utilization Management, Clinical Operations, or health plan operations
  • 2+ years in a leadership or supervisory capacity
  • Strong knowledge of Medicare Advantage, Medicaid, Commercial, and Marketplace UM
  • Familiarity with CMS regulations, NCQA accreditation, and delegation oversight
Nice to have
  • Master's degree
  • Experience with AI-enabled clinical workflows
  • Familiarity with InterQual® or MCG®
  • Lean/Six Sigma/Agile/PM certification
  • Prior UAT/QA experience in a tech environment
What the job really is

The Clinical Integrity Manager at Cohere Health is responsible for overseeing the operational integrity of clinical programs and technology solutions. This role involves collaborating with various departments to ensure clinical practices meet regulatory standards and client expectations, while also contributing to innovation through automation and workflow optimization. The manager will perform clinical reviews, write documentation, and support client implementations, ensuring the clinical integrity is maintained throughout the product lifecycle.

Benefits
  • Fully remote opportunity with about 10% 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
Things to weigh
  • No salary listed in the posting, but a range is provided
  • Role involves hands-on execution which may not appeal to all candidates
  • Requires strong collaboration across multiple departments which may lead to complex dynamics
Job score4.2/5
Benefits3/5
Freshness5/5
Career value4/5
Role clarity4/5
Pay transparency5/5

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