Director of Clinical Integrity & Product Readiness

Cohere Health; Boston (MA); Remote; USD 159,000 - 180,000; Full time

Job summary

Cohere Health is seeking a Clinical Integrity Director, a remote-first leader reporting to the VP of Clinical Integrity. You will own governance, readiness, and end-to-end integrity of clinical programs and technology-enabled solutions across Clinical Operations, Product, Engineering, Client Success, and Compliance.

You will drive multi-workstream accountability, translate regulatory changes into product specs, and ensure timely go-live readiness for client implementations, with occasional

Qualifications

• Active unrestricted clinical license (RN/PT/OT/SLP) and a bachelor's in a clinical field.
• 7+ years in UM/Clinical Ops/Health Plan ops, incl. 3+ years leading programs or teams.
• Strong knowledge of Medicare Advantage, Medicaid, commercial plans, and CMS regs.
• Experience managing multiple workstreams with Product, Engineering, Ops in tech-enabled env.

Responsibilities

• Own and manage clinical integrity governance programs with dashboards.
• Lead clinical impact assessment for policy changes and product updates.
• Manage clinical requirements pipeline to Product and Engineering.
• Translate regulatory and clinical changes into product specs with timelines.
• Oversee operational readiness for product releases and client implementations.
• Lead clinical UAT, assign testing, triage defects, ensure resolution before go-live.
• Develop readiness scorecards for go/no-go visibility.
• Serve as operational point of contact across teams.
• Prepare clinical integrity materials for RFPs, RFIs, questionnaires.
• Lead readiness for new client implementations and feasibility assessments.

Skills

Utilization Management

Clinical Operations

Program management

Cross-functional collaboration

Regulatory knowledge

Education

Bachelor's degree in Nursing, Therapy, Healthcare Administration, or related clinical discipline

Master's degree in Healthcare Administration or MBA

Tools

InterQual/MCG

AI-enabled clinical workflows

Job description

Cohere Health is seeking a Clinical Integrity Director, a remote-first leader reporting to the VP of Clinical Integrity. You will own governance, readiness, and end-to-end integrity of clinical programs and technology-enabled solutions across Clinical Operations, Product, Engineering, Client Success, and Compliance.

You will drive multi-workstream accountability, translate regulatory changes into product specs, and ensure timely go-live readiness for client implementations, with occasional