Account Manager, Provider Success

Opportunity Overview:

Cohere’s Provider & User Management Team is responsible for ensuring consistent delivery of a proactive, supportive, and partner-oriented experience to an assigned portfolio of providers/practices across our health plan-clients’ networks. The Account Manager, Provider Success position is a crucial role in our organization.

In this role, you are responsible for managing a defined portfolio of healthcare provider practices and/or health systems in one or more specialty areas. You will serve as the face of Cohere, responding to escalations and questions for your portfolio while incorporating the unique needs of public-sector programs (e.g., Medicaid, Medicare, state-funded initiatives). Additionally, you will play a proactive role in driving positive change in provider clinical practice patterns by implementing a number of outbound educational and intervention-based campaigns designed by your clinical counterparts.

What you’ll do:

• Be the Main Point of Contact

  • Serve as the go-to resource for providers, supporting education, training, communications, and general platform guidance.
  • Address contracting or administrative questions and help practices understand how to optimize their auto-approval rates.
  • Act as an escalation point for grievances, disagreements with clinical guidelines, and other high-touch needs.

• Lead Program Implementation

  • Support onboarding and ongoing engagement to ensure providers remain aligned with CMS/state requirements and Cohere workflows.
  • Maintain strong working knowledge of regulatory requirements influencing prior authorization and utilization management.
  • Partner with Compliance and Legal to surface potential risks or required communications.

• Drive Proactive Outreach

  • Identify non-adherence or performance trends, then design simple outreach campaigns (email, phone, educational touch points) that encourage positive behavior change.
  • Share best practices and actionable tips to improve auto-approval performance.
  • Ensure all provider interactions uphold HIPAA, privacy standards, and program integrity.

• Monitor Portfolio Performance

  • Use reporting and scorecards to track portfolio health, identify issues, and surface opportunities to improve clinical quality and reduce manual review.
  • Lead recurring check-ins, quarterly reviews, practice calls, workflow discussions to help teams improve approval rates and reduce pends/denials.

• Provide Consultative Support

  • Help practices optimize clinical protocols and prior-auth workflows to reduce friction and increase auto-approvals.
  • Share relevant thought leadership with key strategic partners.
  • Advise practice leadership on how to align Cohere configurations with financial and clinical goals (e.g., bundles, ancillary service alignment).
  • Recommend workflow improvements that accelerate review times and ensure compliance with CMS/state DOH obligations.

• Support Network Implementations

  • Assist with onboarding new client networks and provider groups at scale.
  • Manage high-volume provider onboarding initiatives and periodic refresh trainings as new providers join the network.

What you’ll need:

• Bachelor's degree
• PMP desired but not required
• Willing and able to travel up to ~30% 
• Strong communication skills with the ability to translate policy and process into provider-friendly language.
• 5-10+ years of experience in the health solutions industry (e.g. account management, provider relations, client services, network development, or network operations)
• Direct experience working with government healthcare programs, especially CMS, and engagement with provider and/or member populations
• Strong relationship-building and negotiation skills, particularly in highly regulated or complex healthcare environments
• Ability to independently prioritize across a large provider portfolio and focus effort where it has the highest impact
• Familiarity with Medicare/Medicaid rules, managed care models, and prior authorization processes
• Proven success managing mid- to large-scale projects in healthcare settings
• Strong analytical and technical proficiency, including advanced skills in Excel, Access, and other Microsoft applications 
• Experience with CRM systems, BI or analytics tools, provider data, or project management platforms (Salesforce, Tableau, Jira, Monday.com, etc.) is strongly preferred

 

Pay & Perks:

💻 Fully remote opportunity with about 30% travel

🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program 

📈 401K retirement plan with company match; flexible spending and health savings account 

🏝️ Up to 184 hours (23 days) of PTO per year + company holidays

👶 Up to 14 weeks of paid parental leave 

🐶 Pet insurance  

The salary range for this position is $105,000 to $115,000 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 delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members.

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, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes.

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.

 

 

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