Medical Policy Writer, Oncology

Company Overview:

Cohere Health is a fast-growing clinical intelligence company that’s improving lives at scale by promoting the best patient-specific care options, using leading edge AI combined with deep clinical expertise. In only four years our solutions have been adopted by health insurance plans covering over 15 million people, while our revenues and company size have quadrupled. That growth combined with capital raises totaling $106M positions us extremely well for continued success. Our awards include: 2023 and 2024 BuiltIn Best Place to Work, Top 5 LinkedIn™ Startup, TripleTree iAward, multiple KLAS Research Points of Light, along with recognition on Fierce Healthcare's Fierce 15 and CB Insights' Digital Health 150 lists.

Opportunity Overview:

This is a fantastic opportunity for an outstanding individual to join a rapidly growing digital health company as a Medical Policy Writer to develop content in the Oncology space. You will work closely with scientific literature researchers, clinical leadership, subject matter experts, and stakeholders to ensure the smooth flow of information, facilitate policy development, and maintain up-to-date medical guidelines. Your role will be crucial in drafting, refining, and finalizing medical policies based on comprehensive scientific evidence.

People 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.

Last but not least: People 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.

What you will do:

Oncology-Focused Policy Development:

• Draft, refine, and finalize oncology medical policy documents based on comprehensive scientific evidence.
• Collaborate with scientific literature researchers to incorporate the latest advancements in oncology, including chemotherapy, targeted therapies, immunotherapies, and evolving standards of care.
• Work closely with subject matter experts to translate complex oncology research into clear and actionable policy language.
• Facilitate policy development sessions to refine and clarify policy drafts.
• Ensure policies align with national guidelines (e.g., NCCN, ASCO)
• Provide feedback and guidance to ensure alignment with organizational goals and standards.

Medical Policy Updates and Maintenance:

• Continuously monitor oncology clinical trial data, FDA approvals, and guideline updates to keep policies current.
• Ensure medical policy definitions are current and accurately reflect the latest medical guidelines.
• Regularly review and update medical policies to incorporate the latest scientific evidence and clinical best practices.
• Handle internal requests, scheduled reviews, and updates.
• Ensure policies are compliant with CMS policies such as NCDs and LCDs.

Stakeholder Engagement and Communication:

• Foster strong relationships with key internal stakeholders, including policy writers, medical directors, and clinical leadership.
• Communicate policy changes and updates effectively to all relevant internal parties.

Quality Assurance and Review:

• Conduct quality checks on policy documents before final approval and publication.
• Ensure consistency and accuracy in all policy documents.
• Implement a robust review process involving internal and external experts to validate policy content.

Training and Development:

• Develop and deliver training sessions for policy writers on best practices and organizational standards.
• Provide ongoing support and mentorship to policy writers to enhance their skills and knowledge.

Documentation and Process Management:

• Maintain comprehensive documentation of policy development processes and procedures.
• Develop and manage a repository for policy documents and related resources.
• Ensure all documentation is up-to-date and accessible to relevant stakeholders.
• Post approved policies in Confluence.

Performance Monitoring and Reporting:

• Track and report on the progress of policy development projects.
• Provide regular updates to senior management on policy status, challenges, and achievements.
• Utilize data and metrics to assess the effectiveness of policies and identify areas for improvement.

Your background & requirements:

Required Experience:

• Advanced degree in a life science, pharmacy, medicine, nursing, or related field (e.g., PhD, PharmD, or MSN)
• 3-5 years of experience in medical writing, policy development, or scientific literature research and vetting in oncology.
• Strong understanding of oncology treatments, including chemotherapy, targeted therapies, immunotherapies, and evolving standards of care.
• Knowledge of CMS policies such as NCDs and LCDs and private payor reimbursement landscapes.
• Experience interpreting and summarizing clinical trial data and national guidelines (e.g., NCCN).
• Excellent communication skills, both written and verbal with the ability to translate complex clinical information into clear, concise policy language.
• Understanding of coding, billing, and prior authorization processes in oncology.
• Detail-oriented and enjoy managing simultaneous projects with multiple stakeholders.
• Ability to work independently in a remote work environment with minimal supervision and as part of a team.
• Proficient in using collaboration tools such as Confluence and project management software.
• Utilization review experience and/or certification in medical writing is a plus

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.

The salary range for this position is $80,000.00 to $100,000.00 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.

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