[Remote] Clinical Training & Quality Specialist

Note: The job is a remote job and is open to candidates in USA. Cohere Health is a company that delivers AI-powered solutions to streamline access to quality care. They are seeking a Clinical Quality and Training Specialist to support clinical quality measurement and performance improvement initiatives, focusing on inpatient clinical reviews and operational efficiency.ResponsibilitiesConduct quality audits of inpatient clinical determinations to ensure alignment with clinical guidelines and quality standardsAnalyze QA findings and translate insights into actionable recommendations for operational leaders and cross-functional partnersProvide coaching and feedback to improve clinical decision accuracy, guideline adherence, and overall team performanceDevelop and maintain SOPs, job aids, workflow documentation, and training materials for inpatient review processesFacilitate onboarding and ongoing training for Clinical teams using adult learning principles and subject-matter expertisePartner cross-functionally with Product, Clinical, Client Services, and Operations to implement workflow updates, monitor quality trends, and report performance insights to leadershipSkillsActive RN license2+ years of experience reviewing inpatient utilization management / coverage determinations, with strong familiarity with NCQA and CMS guidelinesExperience applying clinical guidelines (e.g., LCD/NCD) to medical necessity or authorization decisionsExperience conducting quality audits, performance reviews, or QA processes in a clinical operations or utilization management environmentAbility to deliver coaching, feedback, or training to improve clinical decision accuracy and guideline adherenceStrong analytical skills with experience identifying quality trends, root causes, and opportunities for improvementExcellent written and verbal communication skills with the ability to partner effectively with operational and cross-functional stakeholdersProficiency with tools such as Google Workspace (Sheets, Docs, Forms) and comfort working with data, dashboards, or quality reportingBenefitsFully remote opportunity with about 5% travelMedical, dental, vision, life, disability insurance, and Employee Assistance Program401K retirement plan with company match; flexible spending and health savings accountFlexible Time Off + Company HolidaysUp to 14 weeks of paid parental leavePet insuranceCompany OverviewCohere Health is a SaaS company that focuses on improving the efficiency and effectiveness of healthcare delivery. It was founded in 2019, and is headquartered in Boston, Massachusetts, USA, with a workforce of 501-1000 employees. Its website is https://coherehealth.com.