Trend Innovation Specialist
Remote
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 leading edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health insurance plans covering over 15 million people, while our revenues and company size have quadrupled. That growth combined with capital raises totaling $106M positions us extremely well 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, along with recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.
Opportunity Overview:
You will work closely with Clinical Programs and analytics leadership, subject matter experts, product, data science and engineering to support trend innovation and advanced automated decision-making capabilities. The work will be fast-paced and project-based, with evolving needs - requiring adaptability, curiosity, and grace under pressure. Your work will support the expression of clinical policies, programs, and guidelines through rules that power our products and services.
Last but not least: People who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.
What you’ll do:
- Monitor and analyze clinical policies and guidelines to quantify opportunities to drive more appropriate, cost-effective care
- Perform literature searches, review quality measurement organization portfolios, and monitor industry news on an ongoing basis to detect healthcare trends, key drivers and root causes, and ideas for innovative interventions
- Prepare client-ready presentations to clearly summarize analysis results and recommendations
- Analyze policy and legislative initiatives at the state and national level to assess impact on healthcare utilization, cost, quality, and the patient/provider experience
- Collaborate with clinical SMEs,Trend Innovation Leads and operations specialists to identify observation-driven trend opportunities
- Provide insight to data scientists in surfacing meaningful data-driven insights through benchmarking, trend analysis, low value care detection, and patient/provider analytics
- Assist actuarial team with building models to estimate and validate savings projections
- Define additional objectives, key results, and early indicators
- Create reports and clearly communicate findings and prioritized recommendations to key stakeholders
- Partner with Clinical Programs and Product teams to monitor forward-thinking pilot programs to impact validated opportunities
Your background & requirements:
- Bachelor's degree in healthcare or analytics related field with a Master’s degree or higher in a healthcare-related field (nursing, health services research, public health, HEOR, clinical informatics) strongly preferred.
- 1-2+ years of experience working for a payer or multi-specialty provider organization, or comparable experience with a healthcare technology or managed services vendor
- Experience with evidence-based care guidelines (i.e., MCG, InterQual)
- Familiarity with medical coding and standardized clinical terminologies (e.g., ICD-10, CPT, HCPCS, LOINC, SNOMED)
- Working knowledge of data science and machine learning methods
- Exceptional communication skills and a keen ability for translating technical requirements to a less technical audience
- Analytical thinker with superior problem-solving skills and attention to detail
- Ability to thrive in fast-paced start-up environment
- Ability to work both collaboratively and independently in a remote work environment with minimal supervision
- Avid learner with adaptable knowledge base to accommodate frequent changes in clinical guidelines and data requirements
- Experience with quality measures (e.g., HEDIS, MIPS, IQR, NQF) and care management is a plus
Equal Opportunity Statement:
Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.
The salary range for this position will be $80,000-$100,000; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.
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