
Compliance Quality Auditor
Job Description
Remote
Company Overview:
Cohere Health is illuminating healthcare for patients, their doctors, and all those who are important in a patient’s healthcare experience, both in and out of the doctors office. Founded in August, 2019, we are obsessed with eliminating wasteful friction patients and doctors experience in areas that have nothing to do with health and treatment, particularly for diagnoses that require expensive procedures or medications. To that end, we build software that is expressly designed to ensure the appropriate plan of care is understood and expeditiously approved, so that patients and doctors can focus on health, rather than payment or administrative hassles.
Opportunity Overview:
This role will be primarily responsible for performing clinical compliance and quality audits to ensure compliance with federal and state regulations, NCQA, URAC and client contractual requirements. This role will also assist with data collection, analysis and reporting for process improvement efforts.
The Compliance Quality Auditor will plan, coordinate, and conduct compliance audits at the direction of the Manager of ...
The Real Dill ☘️
A nuance of the American healthcare and insurance system that is incredibly frustrating: prior authorizations for approved care. Traditionally manually, slow, and opaque, Cohere found a way to use AI to automate the preauthorization process, streamlining approvals for prospective patients while helping providers generate more revenue, more predictably, more quickly. This is one of the many administrative functions in healthcare that is being entirely transformed through AI, and it makes sense. Rather than taking weeks (or months) to get an answer about whether a patient can be seen with their insurance coverage, automating the process provides value for patients, providers, and payers alike. (May 2024)
Jon Lee, PT, DPT, OCS, FAAOMPT, MBA
Pickle co-founder
About Cohere Health
Streamlined clinical pre-authorization for evidence-based healthcare decisions
MissionTo ensure a collaborative healthcare journey by allowing patients, physicians, and clinical plans work together to get the right value.
Wow FactorClaims 5.5 million intelligent prior authorizations annually for more than 15 million health plan members and 420,000 healthcare providers
Company benefits
- 🔐 Health insurance
- 🦷 Dental
- 👀 Vision
- 🏦 401K/retirement
- 🐣 Maternity/paternity leave
- 📕 Learning and development allowance
- 🏖️ Paid vacation leave
Pickle is not affiliated with listed companies unless otherwise noted.
The job search that fits your personality
Personalized matches for clinicians, for the coolest jobs in the clinic or beyond