Medical Director – Spine Surgery

This is a fully remote position, open to applicants in Alaska, +12 more states.

📋 Description

• Assess the medical appropriateness of services by reviewing clinical information and utilizing evidence-based guidelines.

• Deliver prompt medical reviews that align with Cohere's quality standards.

• Make clinical decisions based on evidence-based criteria and professional judgment.

• Record communication and decision-making processes in Cohere's workflow tools.

• Utilize correct templates during the case review process.

• Adhere to established turnaround times for clinical reviews.

• Engage in peer-to-peer discussions with treating providers to clarify details and communicate review results.

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

• Uphold professionalism, accountability, and service in interactions with colleagues and providers.

• Contribute to projects that enhance the team’s clinical knowledge and efficiency.

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

⛳️ Requirements

• Completion of a US-based residency program in Orthopedic or Neurosurgery Surgery, along with a fellowship in Spine Surgery.

• Board certification as an MD or DO, holding a current unrestricted state license to practice medicine; reviewers must maintain required credentials to keep the position.

• Over 5 years of clinical experience beyond residency/fellowship.

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

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

• Licensure in AZ, GA, MS, NC, ND, OK, OR, or TX is highly desirable.

• Willingness to acquire additional state licenses with support from Cohere.

• This role is not available for hire in AK, CA, CO, HI, NY, or WA.

🏝️ 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 plus company holidays.

• Up to 14 weeks of paid parental leave.

• Pet insurance included.

• Bonus is part of the overall benefits package.