Medical Director, Operations, Cardiovascular

Cohere Health; United States; Remote; USD 275,000 - 295,000; Full time

Job summary

Cohere Health is seeking a Medical Director for Operations in Cardiovascular to lead a team of Associate Medical Directors. This role involves clinical reviews, team management, and developing operational procedures in a fast-paced, remote environment. Ideal candidates will have a completed residency in Internal Medicine, a fellowship in Cardiology, and significant clinical experience. Join a rapidly growing company committed to improving patient care through innovative solutions.

Benefits

Comprehensive benefits package

Health insurance

401k

Bonus opportunities

Qualifications

• 5+ years of clinical practice post-residency/fellowship.
• Experience with clinical decision criteria sets (e.g., Milliman, InterQual).
• Membership in relevant specialty societies preferred.

Responsibilities

• Lead a team of Cardiology Associate Medical Directors for clinical reviews.
• Manage a remote workforce efficiently.
• Develop and document standard operating procedures.

Skills

Interpersonal skills

Communication skills

Multitasking

Attention to detail

Flexibility

Autonomy

Education

Completed US residency in Internal Medicine

Fellowship in Cardiology

Board-certified MD or DO

Tools

Mac

Google Suite

Job description

Medical Director, Operations, Cardiovascular

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Medical Director, Operations, Cardiovascular

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Company Overview
Cohere Health is a fast-growing clinical intelligence company that’s improving lives at scale by promoting the best patient-specific care options, using cutting-edge AI combined with deep clinical expertise. In only four years, our solutions have been adopted by health plans covering over 15 million lives, with revenues and company size quadrupling. Our growth, supported by capital raises totaling $106M, positions us for continued success. Our awards include: 2023 and 2024 BuiltIn Best Place to Work; Top 5 LinkedIn Startup; TripleTree iAward; multiple KLAS Research Points of Light awards; recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.

Opportunity Overview
We are seeking a Medical Director to lead our Cardiology Associate Medical Directors and perform clinical reviews. Reporting to the Senior Medical Director, this role is part of a review team that includes non-clinical intake specialists and nurses. It is a critical position that is rapidly scaling to impact millions of patients. The environment is fast-paced, requiring quick learning, hands-on approach, adaptability, and effective communication across diverse backgrounds. This is a permanent remote, full-time position.

What You Will Do

• Lead a team of Cardiology Associate Medical Directors responsible for prior authorization clinical reviews and peer-to-peer discussions
• Inspire and motivate team members to perform at their best
• Oversee and collaborate with staff effectively
• Manage a remote workforce efficiently
• Identify problems and work towards solutions to maximize efficiency and revenue
• Develop and document standard operating procedures
• Maintain professionalism, accountability, and service excellence
• Perform clinical reviews daily (50%)
• Provide timely, quality medical reviews based on evidence-based criteria
• Document all decisions clearly and accurately
• Meet turnaround times for clinical reviews
• Conduct peer-to-peer discussions with providers to clarify clinical information and explain decisions
• Support development and review of clinical guidelines
• Review Medical Coverage Policies regularly
• Stay updated on literature, standards of care, and regulations
• Maintain necessary credentials and report adverse license actions
• Perform other delegated duties

Required Qualifications

• Completed US residency in Internal Medicine and fellowship in Cardiology
• Board-certified MD or DO with an active, unrestricted state license
• 5+ years of clinical practice post-residency/fellowship

Preferred Qualifications

• 2+ years managed care utilization review experience
• 1+ years supervision/management experience in utilization management or payor organization
• Experience with clinical decision criteria sets (e.g., Milliman, InterQual)
• Membership in relevant specialty societies
• Licensure in MN, VA, ND, IL, or TX preferred; willingness to obtain additional licenses

Competencies and Success Factors

• Ability to multitask and organize effectively
• Strong interpersonal and communication skills
• Experience working remotely and with diverse teams
• Proficiency with Mac and Google Suite
• Comfort with technology and learning new tools
• Understanding of managed care regulations
• Attention to detail, flexibility, and autonomy

We look forward to learning more about you and welcoming you to Cohere Health!

Equal Opportunity Statement
Cohere Health is an Equal Opportunity Employer committed to diversity and inclusion. We support a respectful environment where all are valued.

The salary range is $275,000 to $295,000 annually, with a comprehensive benefits package including health insurance, 401k, and bonus. Compensation is ultimately based on qualifications, experience, and internal factors.