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.
This is an excellent opportunity for an outstanding data analyst to join a Series B digital health company. You will work closely with clinicians, program implementation and operation experts, informaticists, data scientists, and actuaries to monitor and report core UM impact on reducing medical expenses of our specialty programs. The core UM impact is generated via appropriately preventing services not meeting medically necessary criteria, through nudges, authorization withdrawal and denial. The work will be fast-paced and project-based, with evolving needs requiring adaptability, curiosity, and grace under pressure.
Last but not least: People who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.
What you’ll do:
- Quickly understand Cohere’s clinical content, products, services and clinical programs and how Cohere’s x-functional collaboration and workflow intersect with healthcare providers’ workflow and patients’ care journey.
- With senior actuary’s mentorship,
- Develop reports in Tableau (or Excel using automated formula) based on prior authorization data, complemented by claims data, to demonstrate Cohere’s impact on utilization and medical expense, generated by activities such as nudges, withdrawals and denials. The reports need to show impact by LOB, clinical modality, service category and care path.
- Communicate data needs and define specifications for data management team’s support for standardizing data components to support scalable, automated and productized impact reports.
- Establish internal cadence (at least bi-monthly) to report core UM impact to clinical programs, clinical intelligence, rules, and client management teams. The cadence should include UM impact performance, trend and insights into any unexpected changes/trends.
- Prepare client facing impact reporting materials (e.g., presentation deck at least bi-monthly) and talking points to support program leaders for client report out meetings.
- Conduct exploratory analysis (e.g., auth data, salesforce clinical review notes and claims data) to understand trends and unexpected changes of impact rate, as well as to address client ad hoc questions.
- Maintain, regular review and update of report methodology and specifications.
- Passionate about improving the U.S. healthcare system and helping ensure every patient receives the best care possible.
- Self-starter, able to work independently, able to succeed in a fast-paced, high intensity start-up environment
- Strong written and verbal communication skills
- 2-5 years of professional experience in healthcare analysis (payer, provider, consulting), with demonstrated quantitative analytical and critical thinking skills
- Advanced knowledge of standard medical and clinical data including prior authorization data, medical claims, pharmacy, and eligibility data
- Advanced knowledge of analytical and programing languages, (e.g., SQL or R, Python or equivalent statistical and analytical softwares)
- Experience and knowledge of Tableau, Kibana (or similar BI tool) is required
- Master’s Degree in Public Health, Health Policy, Biostatistics, or Health Economics preferred.
We can't wait to meet you and learn all about you at Cohere Health!
Equal Opportunity Statement:
Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.