Medical Director – Orthopedic Surgery

This is a fully remote position, open to applicants in Arizona, +5 more states.

📋 Description

• Oversee the delivery of Cohere’s musculoskeletal and orthopedic programs by assessing the medical appropriateness of services.

• Examine clinical information and employ evidence-based guidelines for evaluations.

• Ensure timely medical reviews that align with Cohere’s quality standards.

• Utilize evidence-based criteria and clinical expertise to make clinical determinations.

• Accurately document communications and decision-making within Cohere workflow tools.

• Utilize appropriate templates during the case review process.

• Adhere to turnaround times for clinical evaluations.

• Engage in peer-to-peer discussions with treating providers for information clarification and review outcome explanations.

• Offer feedback on alternative treatments based on medical necessity criteria and evidence-based research.

• Maintain professional interactions with Cohere colleagues and providers.

• Contribute to projects that enhance team clinical expertise and operational efficiency.

• Assist in operational improvements and member/provider experiences related to clinical review tasks.

⛳️ Requirements

• Completion of a US-based residency program in Orthopedic Surgery.

• Board certification by the appropriate specialty board as an MD or DO.

• Current unrestricted state license to practice medicine; reviewers must uphold necessary credentials for this position.

• More than 5 years of clinical practice following residency/fellowship.

• At least 1 year of experience in managed care utilization review is preferred.

• Membership in national and/or regional specialty societies is preferred.

• Licensure in AZ, FL, MN, ND, OR, or TX is highly desirable.

• Openness to obtaining additional state licenses with support from Cohere.

🏝️ Benefits

• Fully remote position with approximately 5% travel required.

• Comprehensive medical, dental, vision, life, and disability insurance, along with an Employee Assistance Program.

• 401K retirement plan with company matching contributions.

• Flexible spending and health savings accounts available.

• Flex Time Off in addition to company holidays.

• Up to 14 weeks of paid parental leave offered.

• Pet insurance included.

• Bonus provided as part of the overall benefits package.

• Assistance available for obtaining additional state licenses.