Clinical Training & Quality Specialist
Cohere Health · United States
- Hybrid
- Full-time
- $75,000 / year
- United States
Job highlights
- Analyze clinical quality and drive performance improvements.
- Conduct audits and provide coaching to clinical teams.
- Develop training materials and SOPs for clinical reviews.
- Collaborate with cross-functional teams on workflow updates.
- Fully remote RN role with competitive salary and benefits.
About the role
Opportunity Overview
Cohere Health is seeking a Clinical Quality and Training Specialist to join our Training and Quality team. This role focuses on supporting clinical quality measurement and performance improvement initiatives for inpatient clinical reviews, aiming to enhance operational efficiency while maintaining high standards of clinical quality. You will collaborate closely with Clinical Operations to deliver training, feedback, and coaching, leveraging your expertise to improve team performance. A strong background in quality analysis, training, and continuous improvement is essential, alongside the ability to manage both daily QA tasks and long-term projects in a dynamic setting.
What You’ll Do
- Conduct quality audits for inpatient clinical determinations to ensure adherence to guidelines and standards.
- Analyze QA findings and provide actionable recommendations to operational leaders and partners.
- Offer coaching and feedback to enhance clinical decision accuracy and guideline adherence.
- Develop and maintain Standard Operating Procedures (SOPs), job aids, workflow documentation, and training materials for inpatient review processes.
- Facilitate onboarding and ongoing training for Clinical teams, applying adult learning principles.
- Collaborate with Product, Clinical, Client Services, and Operations teams to implement workflow updates, monitor quality trends, and report performance to leadership.
What You’ll Need
- Active RN license.
- Experience with inpatient utilization management/coverage determinations, including NCQA and CMS guidelines.
- Proficiency in applying clinical guidelines (e.g., LCD/NCD) to medical necessity or authorization decisions.
- Experience in conducting quality audits, performance reviews, or QA processes within clinical operations or utilization management.
- Demonstrated ability to coach, provide feedback, or train to improve clinical decision accuracy and guideline adherence.
- Strong analytical skills for identifying quality trends, root causes, and improvement opportunities.
- Excellent written and verbal communication skills for effective stakeholder collaboration.
- Proficiency with Google Workspace (Sheets, Docs, Forms) and experience with data, dashboards, or quality reporting.
Pay & Perks
- Fully remote opportunity with approximately 5% travel.
- Comprehensive benefits: Medical, dental, vision, life, disability insurance, and Employee Assistance Program.
- 401K retirement plan with company match, flexible spending, and health savings accounts.
- Flexible Time Off plus Company Holidays.
- Up to 14 weeks of paid parental leave.
- Pet insurance.
The salary range for this position is $70,000 to $80,000 annually, as part of a total benefits package. Individual pay decisions depend on qualifications, experience, skillset, and internal alignment.
Interview Process
- Connect with Talent Acquisition for a Preliminary Phone Screening
- Hiring Manager Interview
- Cross-Functional Interview
- Leadership Interview
Note: The interview process is subject to change.
About Cohere Health
Cohere Health's clinical intelligence platform uses AI to enhance payer-provider collaboration, cost containment, and healthcare economics, streamlining access to quality care. The company partners with over 660,000 providers and manages over 12 million prior authorization requests annually, with AI auto-approving up to 90% of requests. Through the acquisition of ZignaAI and the launch of its Payment Integrity Suite, Cohere Health offers AI-driven clinical and coding validation. Cohere Health has received industry recognition, including the Inc. 5000 list, Gartner Hype Cycle, and LinkedIn Startup rankings. Backed by investors like Deerfield Management and Polaris Partners, Cohere Health aims to create a more transparent healthcare ecosystem.
The Coherenauts (employees) are empathetic, candid, kind, caring teammates who embody the company's core values. Cohere Health is committed to fostering a supportive, growth-oriented, and diverse environment.
Key skills/competency
- Clinical Quality Auditing
- Training and Development
- Quality Assurance (QA)
- Utilization Management
- NCQA Guidelines
- CMS Guidelines
- Performance Improvement
- Clinical Operations
- Root Cause Analysis
- Adult Learning Principles
Skills & topics
- Clinical Quality Specialist
- Training Specialist
- Quality Assurance
- Utilization Management
- Inpatient Review
- RN
- Healthcare Quality
- Performance Improvement
- Clinical Operations
- NCQA
How to get hired
- Tailor your resume: Highlight your RN experience, inpatient utilization review, NCQA/CMS guidelines, and QA/auditing skills.
- Craft a strong cover letter: Emphasize your coaching abilities and experience with clinical training and quality improvement.
- Prepare for interviews: Be ready to discuss specific examples of quality audits, training delivery, and cross-functional collaboration.
- Research Cohere Health: Understand their AI-powered platform, mission, and commitment to transparency and quality care.
Technical preparation
Behavioral questions
Frequently asked questions
- What is the salary range for the Clinical Training and Quality Specialist role at Cohere Health?
- The salary range for the Clinical Training and Quality Specialist position at Cohere Health is $70,000 to $80,000 annually, in addition to a comprehensive benefits package including health insurance, 401k, and potential bonus opportunities.
- Is the Clinical Training and Quality Specialist position at Cohere Health remote?
- Yes, the Clinical Training and Quality Specialist role at Cohere Health is a fully remote opportunity, with an estimated 5% travel requirement.
- What are the key qualifications for the Clinical Training and Quality Specialist role?
- Key qualifications include an active RN license, experience with inpatient utilization management, familiarity with NCQA and CMS guidelines, experience in quality audits or QA processes, strong analytical and communication skills, and proficiency with Google Workspace.
- What kind of benefits does Cohere Health offer for this role?
- Cohere Health offers a robust benefits package including medical, dental, vision, life, and disability insurance, an Employee Assistance Program, a 401K with company match, flexible spending accounts, health savings accounts, flexible time off, company holidays, paid parental leave, and pet insurance.
- How does Cohere Health use AI in its operations?
- Cohere Health utilizes an AI-powered clinical intelligence platform to improve payer-provider collaboration, streamline prior authorization requests (auto-approving up to 90%), and enhance payment integrity through solutions like Cohere Validate™.
- What is the interview process for the Clinical Training and Quality Specialist position?
- The typical interview process includes a preliminary phone screening with Talent Acquisition, followed by interviews with the Hiring Manager, a Cross-Functional team, and Leadership.
- What is the company culture like at Cohere Health?
- Cohere Health fosters a culture of empathetic teamwork, encouraging candid communication and embodying core values. They are committed to creating a supportive, growth-oriented, and diverse environment for all employees.