Remote Clinical Quality & Training Specialist

Cohere Health; Northern (KY); Hybrid; USD 70,000 - 78,000; Full time

Benefits offered by this job

Health insurance

401k with company match

Paid parental leave

Job summary

Cohere Health is seeking a Clinical Quality and Training Specialist to join the Training and Quality team. You will implement clinical quality measurements, scoring, and performance improvement data designed to improve efficiency while exceeding industry standards for quality and clinical guidance.

You will guide and support training needs, developing clinical training and development initiatives. Fully remote opportunity with about 5% travel.

Qualifications

• Active RN licensure required.
• 2+ years experience with Coverage Determinations in healthcare.
• Familiarity with NCQA and CMS Utilization Management standards.
• Experience using quality management systems and conducting QA audits.

Responsibilities

• Audit Operations team members on clinical decisions against guidelines.
• Translate QA findings into insights for leaders and partners.
• Develop and deploy structured coaching sessions based on audit findings.
• Create SOPs, job aids, workflow guides, and product readiness materials.
• Facilitate onboarding and upskilling for Clinical teams using adult learning principles.
• Lead QA/Training during project implementations and drive quality improvements.
• Collaborate with Product, Clinical, Client Services, and Operations to validate workflow changes.
• Support change management by communicating process updates and QA expectations.
• Serve as SME adviser to frontline leaders on quality trends and readiness.
• Manage multiple priorities with independence and accountability.
• Step into operational queues to maintain service levels during high volumes.
• Coach team members for improvement against quality metrics; report to Sr Leadership.

Skills

RN licensure

Coverage determinations

QA audits

Adult learning theory

Tools

Google Workspace

Job description

Cohere Health is seeking a Clinical Quality and Training Specialist to join the Training and Quality team. You will implement clinical quality measurements, scoring, and performance improvement data designed to improve efficiency while exceeding industry standards for quality and clinical guidance.

You will guide and support training needs, developing clinical training and development initiatives. Fully remote opportunity with about 5% travel.