Medical Reviewer, Physician Assistant

Medical Reviewer, Physician Assistant

We are looking for an orthopedic spine Physician Assistant to help deliver on Cohere's musculoskeletal and orthopedic programs by determining the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines. The physician assistant should have previous experience in managing spine conditions in an office setting as well as assisting on spine cases in the operating room.

Reporting to the Managing Medical Director MSK Spine and Ortho for Cohere Health, and part of the review team that includes non-clinical intake specialists, nurses and physicians, this is a critical role in a Series B company that is rapidly scaling to impact millions of patients. This is a fast-paced environment that favors people who are able to learn quickly, be hands-on, and communicate effectively with people of different backgrounds and perspectives. Training and supervision will be provided.

This is a remote-first role that may require travel to Boston, MA for new hire onboarding and occasional in-person team meetings and company events.

What you'll do:

• Provide timely medical reviews that meet Cohere's stringent quality parameters
• Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen
• Clearly and accurately document all communication and decision-making in Cohere workflow tools, ensuring a member and provider can easily reference and understand your decision.
• Use correct templates for documenting decisions during case review
• Meet the appropriate turn-around times for clinical reviews
• Demonstrate the highest level of professionalism, accountability, and service in your interactions with Cohere teammates and providers
• Support projects specific to building the team's clinical expertise and efficiency, as delegated
• Support the team on operational improvements and member/provider experience involving clinical review tasks, as delegated
• Clearly communicate with team members

What you'll need:

• Graduate of an accredited Physician Assistant program
• Current NCCPA certification (PA-C) and active, unrestricted Physician Assistant license in at least one U.S. state
• 3+ years of clinical experience supporting orthopedic spine surgeons and/or neurosurgeons treating spine conditions
• Utilization management, prior authorization, or medical review experience a plus
• Membership in organizations such as the AAPA or specialty spine organizations

Pay & Perks:

• Fully remote opportunity with about 5% travel
• Medical, dental, vision, life, disability insurance, and Employee Assistance Program
• 401K retirement plan with company match; flexible spending and health savings account
• Flex Time Off + company holidays
• Up to 14 weeks of paid parental leave
• Pet insurance
• The salary range for this position is $120,000 to $135,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

Interview Process*:

1. Connect with Talent Acquisition for a Preliminary Phone Screening
2. Meet your Hiring Manager!
3. Behavioral Interview(s)

*Subject to change

About Cohere Health:

Cohere Health's clinical intelligence platform and agentic AI-powered solutions connect health plans' strategic goals and providers' needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuumincluding policy, prior authorization, payment accuracy, and morethe company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.

With the acquisition of ZignaAI, we've further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.

Cohere Health's innovations continue to receive industry wide recognition. We've been named to the 2025 Inc. 5000 list and in the Gartner Hype Cycle for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners.

The Coherenauts, as we call ourselves, 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.

We can't wait to learn more about you and meet 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.