Medical Director Spine Surgery

Responsibilities

• Provide timely medical reviews that meet Cohere's stringent quality parameters
• Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen
• Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision
• Use correct templates for documenting decisions during case review
• Meet the appropriate turn-around times for clinical reviews
• Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research
• Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
• Support projects specific to building the team's clinical expertise and efficiency, as delegated
• Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated

Requirements

• Completed US-based residency program in Orthopedic or Neurosurgery Surgery and fellowship program in Spine Surgery
• Board certification as an MD or DO with a current unrestricted state license to practice medicine - reviewers must maintain necessary credentials to retain the position
• 5+ years of clinical practice beyond residency/fellowship
• 1+ years of managed care utilization review experience
• Membership in national and/or regional specialty societies
• Licensure in AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable - you should be willing to obtain additional state licenses with Cohere's support
• Pay & Perks:
• 💻 Fully remote opportunity with about 5% 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
• Interview Process*:
• Connect with Talent Acquisition for a Preliminary Phone Screening
• Meet your Hiring Manager!
• Behavioral Interview(s)
• *Subject to change
• About Cohere Health:
• The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are cand

Benefits

Additional Information

Opportunity Overview: We are looking for physicians who have expertise in Orthopedic Spine Surgery to deliver on Cohere's musculoskeletal and orthopedic programs by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. Reporting to the Managing Medical Director, MSK Spine and Ortho for Cohere Health, and part of the review team that includes non-clinical intake specialists and nurses, this is a critical role in a Series B company that is rapidly scaling to impact millions of patients. This is a fast-paced environment that favors people who are able to learn quickly, be hands-on, handle ambiguity, and communicate effectively with people of different backgrounds and perspectives.

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