p>What you'll need: • Active RN license • Experience reviewing inpatient utilization management / coverage determinations, with strong familiarity with NCQA and CMS guidelines • Experience applying clinical guidelines (e.g., LCD/NCD) to medical necessity or authorization decisions • Experience conducting quality audits, performance reviews, or QA processes in a clinical operations or utilization management environment • Ability to deliver coaching, feedback, or training to improve clinical decision accuracy and guideline adherence • Strong analytical skills with experience identifying quality trends, root causes, and opportunities for improvement • Excellent written and verbal communication skills with the ability to partner effectively with operational and cross-functional stakeholders • Proficiency with tools such as Google Workspace (Sheets, Docs, Forms) and comfort working with data, dashboards, or quality reporting. 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.