Correspondence and Clinical Process Manager

Cohere Health

3d • $110,000 - $123,000 • Remote

About The Position

We are seeking a Correspondence and Clinical Process Manager to join our Clinical Operations team. In this role, you will work closely with the clinical operations leadership team at Cohere and report to the Sr. Director of Clinical Process and Standards. As part of the Clinical Operations organization, this role will support new implementation and change initiatives to ensure quality, consistency and scalability in a fast-paced, rapidly expanding environment. This is an opportunity to make an impact on the way the clinical ops team members perform their roles by reducing unnecessary variation, simplifying and incorporating automation, and collaborating with the product team to leverage technology to support.

Requirements

• Bachelor's degree in healthcare and active clinical licensure in your state of residence (RN, PT/OT/SLP considered)
• 3+ years of experience in utilization management operations
• Working knowledge of healthcare regulations and accreditation requirements (CMS, Medicaid, JCAHO)
• Skilled with spreadsheets (Excel, Google Sheets) for data analysis and quantitative decision-making, and comfortable building decks (PPT, Google Slides)
• Hands-on experience implementing process improvements, with policy/procedure or work instruction development a plus
• Independent, outcomes-oriented problem solver comfortable operating in ambiguous, fast-paced environments
• Strong communication and stakeholder management skills, with the ability to influence without direct authority

Nice To Haves

• Leadership experience in healthcare operations, payer/provider communications, or utilization management a plus
• Experience with automation technologies and workflow platforms; AI/ML exposure in utilization management a plus
• Lean Six Sigma certification, change management experience, or experience translating operational needs into business requirements a plus

Responsibilities

• Support clinical process improvement initiatives and new delegated client initiatives
• Monitor performance and influence performance to client SLAs
• Conduct root cause analyses, support remediation plan development and remediation execution for process variation, including CAPs
• Collaborate with product team and analytics team
• Understand current clinical operations processes deeply and assess performance to work instructions, P&Ps
• Support development and update of work instructions
• Ensure processes are compliant with regulations and accreditation requirements
• Support optimization of letters process and template tracking

Benefits

• Medical, dental, vision, life, disability insurance, and Employee Assistance Program
• 401K retirement plan with company match; flexible spending and health savings account
• Flex Time Off + company holidays
• Up to 14 weeks of paid parental leave
• Pet insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level