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Salary: USD 159,000 - 180,000 / annual
Cohere Health is seeking a Clinical Integrity Director to lead operational programs that ensure clinical governance, integrity, and readiness across the company's clinical programs and technology-enabled solutions. Reporting to the VP of Clinical Integrity, you will own the day-to-day execution of clinical integrity workstreams—from governance documentation and product testing to implementation readiness and cross-functional coordination.
You will manage clinical integrity governance programs including reviews, documentation, tracking, frameworks, checklists, and dashboards across all active programs. Key responsibilities include managing the clinical impact assessment process for policy changes, product updates, and regulatory shifts; owning the clinical requirements pipeline by managing intake, prioritization, and delivery to Product and Engineering teams; and translating regulatory and clinical changes into product specifications with tracked timelines and dependencies.
You will own the operational readiness program for product releases and client implementations, including timelines, milestones, and cross-functional accountability. This includes managing the end-to-end clinical UAT process—assigning testing, reviewing results, triaging defects, and ensuring resolution before go-live. You will develop and maintain readiness scorecards providing leadership with clear go/no-go visibility for each release or implementation.
Additionally, you will serve as a primary operational point of contact for Clinical Integrity across Product, Engineering, Clinical Operations, Compliance, and Client Success; manage preparation of clinical integrity materials for RFPs, RFIs, and client questionnaires; and lead clinical readiness activities for new client implementations and feasibility assessments for prospective client requirements.
This is a remote-first role with approximately 10% travel, primarily to Boston, MA for new hire onboarding and occasional in-person team meetings and company events.
Cohere Health's clinical intelligence platform uses agentic AI-powered solutions to connect health plans' strategic goals with providers' needs, optimizing speed, cost, and quality of care. The company has been recognized on the 2025 Inc. 5000 list and in the Gartner Hype Cycle for U.S. Healthcare Payers (2022-2025).
**Requirements:**
- Active unrestricted clinical license (RN, PT, OT, or SLP) and Bachelor's degree in Nursing, Therapy, Healthcare Administration, or related clinical discipline
- 7+ years of progressive experience in Utilization Management, Clinical Operations, or Health Plan operations, including 3+ years managing programs, projects, or teams
- Strong knowledge of Medicare Advantage, Medicaid, Commercial, and Marketplace utilization management, as well as CMS regulations, NCQA accreditation standards, and state regulatory requirements
- Demonstrated experience managing multiple concurrent workstreams and cross-functional projects involving Product, Engineering, and Operations teams in a fast-paced, technology-enabled environment
- Proven ability to drive accountability, manage timelines, and deliver results through others with strong organizational, communication, and problem-solving skills
- Plus: Master's degree in Healthcare Administration or Business Administration, Lean/Six Sigma/Agile/PMP certification, and experience with clinical UAT programs, InterQual®/MCG®, or AI-enabled clinical workflows
