Medical Director – Therapy

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist the clinical content team in evaluating clinical decision guidelines and evidence-based research.

• Offer expert insights on content aimed at impacting physicians and enhancing patient outcomes.

• Deliver timely medical evaluations adhering to quality and timeliness standards.

• Make clinical judgments utilizing evidence-based criteria, clinical expertise, medical literature, and guidelines from medical societies.

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

• Utilize appropriate templates for recording medical necessity decisions during case evaluations.

• Engage in peer-to-peer discussions with treating providers to clarify clinical details and elucidate review outcomes.

• Provide recommendations on alternative treatments based on medical necessity criteria and evidence-based studies.

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

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

• Aid in operational enhancements and improve member/provider experiences related to clinical review functions.

⛳️ Requirements

• Successfully completed a US-based residency program in PM&R, Family Practice, Pediatrics, or Internal Medicine.

• Possess board certification as an MD or DO.

• Hold a current unrestricted state license to practice medicine; reviewers must maintain the necessary credentials to continue in the role.

• Have 5+ years of clinical practice experience beyond residency/fellowship in the specified specialties.

• Familiarity with Therapy programs (PT/OT/SLP) in both outpatient and inpatient settings.

• Knowledge of the managed care regulatory framework and processes.

• Comfortable with technology and eager to learn new software tools.

• Capable of thriving in a matrix organization.

• Detail-oriented, adaptable, and able to work independently with minimal supervision.

• 1+ years of managed care utilization review experience in Therapy (PT/OT/SLP) is highly desirable.

• Licensure in AR, MO, MN, NC, IN, TX, NE is highly desirable; willingness to obtain additional state licenses with Cohere's assistance.

🏝️ 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 featuring company matching.

• Flexible spending and health savings accounts available.

• Flex Time Off in addition to company holidays.

• Up to 14 weeks of paid parental leave provided.

• Pet insurance options available.

• Bonus included as part of the overall benefits package.