Cohere Health is a healthcare technology company, focused on improving the efficiency and effectiveness of healthcare delivery. Backed by Flare Capital Partners.
About the role
We are seeking a technology-savvy clinical leader with strong Utilization Management (UM) expertise to join Cohere Health as the Clinical Integrity Director. Reporting to the Vice President of Clinical Integrity, this role is a program-level operational leader responsible for managing the day-to-day integrity, governance, and readiness of Cohere's clinical programs and technology-enabled solutions.
What they're looking for
- Active unrestricted clinical license (RN, PT, OT, or SLP) and a Bachelor's degree in Nursing, Therapy, Healthcare Administration, or related clinical discipline
- 7+ years of progressive experience in Utilization Management, Clinical Operations, or Health Plan operations, including 3+ years managing programs, projects, or teams
- Strong knowledge of Medicare Advantage, Medicaid, Commercial, and Marketplace utilization management, as well as CMS regulations, NCQA accreditation standards, and state regulatory requirements
- Demonstrated experience managing multiple concurrent workstreams and cross-functional projects involving Product, Engineering, and Operations teams in a fast-paced, technology-enabled environment
- Proven ability to drive accountability, manage timelines, and deliver results through others with strong organizational, communication, and problem-solving skills
- Master's degree in Healthcare Administration or Business Administration, Lean/Six Sigma/Agile/PMP certification, and experience with clinical UAT programs, InterQual®/MCG®, or AI-enabled clinical workflows are a plus
More about this role
We are seeking a technology-savvy clinical leader with strong Utilization Management (UM) expertise to join Cohere Health as the Clinical Integrity Director. Reporting to the Vice President of Clinical Integrity, this role is a program-level operational leader responsible for managing the day-to-day integrity, governance, and readiness of Cohere's clinical programs and technology-enabled solutions.
While the Vice President sets enterprise strategy and provides executive-level clinical oversight, the Director owns the operational programs that bring that strategy to life. This leader manages clinical integrity workstreams end-to-end — from governance documentation and product testing to implementation readiness and cross-functional coordination — ensuring nothing falls through the cracks as Cohere scales.
The Director works across Clinical Operations, Product, Engineering, Client Success, and Compliance to ensure clinical integrity is operationalized consistently. This role requires someone who can manage multiple concurrent workstreams, drive accountability across teams, and step in hands-on when needed.
This is a remote-first role that may require travel to Boston, MA for new...
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