Cohere Health
Clinical Integrity Manager
$96K–$125K
United States · Manager · Full-time · Posted Sep 8, 2026
- Experience
- 5+ years in Utilization Management, Clinical Operations, or health plan operations, including 2+ years in a leadership or supervisory capacity.
- Education
- Bachelor's degree in Nursing, Therapy, Healthcare Administration, or a related field.
About the job
Leads clinical integrity operations for utilization management programs, ensuring workflows and technology meet evidence-based, regulatory, client, and operational requirements.
What you'll do
- Review clinical products, workflows, and programs; define clinical requirements and represent clinical integrity in product and engineering work.
- Lead release and implementation readiness through UAT, testing, defect tracking, and audits of client commitments and SLAs.
- Maintain governance documentation and partner across teams on clinical operations, implementation, and business growth.
What they ask for
- Active, unrestricted RN, PT, OT, or SLP license and a bachelor's degree in Nursing, Therapy, Healthcare Administration, or a related field.
- 5+ years of progressive experience in Utilization Management, Clinical Operations, or health plan operations, including 2+ years in leadership or supervision.
- Knowledge of Medicare Advantage, Medicaid, Commercial, and Marketplace UM, CMS regulations, NCQA accreditation, and delegation oversight.
- Experience partnering with Product and Technology teams to shape clinical workflows and digital solutions.
Nice to have
- Master's degree; AI-enabled clinical workflow experience; InterQual® or MCG® familiarity; Lean/Six Sigma/Agile/PM certification; or tech-environment UAT/QA experience.
Pay
$96,000 to $125,000 annually (base salary)
Tools
InterQual®, MCG®
AI focus
Supports responsible adoption of AI-enabled clinical solutions, including defining requirements and testing AI-enabled capabilities.
Model-written summary · the original posting is authoritative