Chance Overview:

The Sr. Director, GIC India Clinical Operations is a foundational leadership role responsible for establishing, scaling, and managing the clinical RN review function within Cohere Health's Global Innovation Center (GIC) in Hyderabad, India. This leader will build a high-performing team of US NCLEX-certified Registered Nurses (NCLEX-RNs) who perform prospective, concurrent, and retrospective clinical reviews for prior authorization cases on behalf of Cohere Health's US payer clients. The Sr. Director will be accountable for the end-to-end clinical operations delivery from the India GIC, ensuring that RN reviewers assess medical records and clinical documentation for appropriateness and medical necessity in strict alignment with clinical guidelines (including MCG Care Guidelines), Cohere Health internal criteria, National and Local Coverage Determinations (NCD/LCD), and regulatory standards (CMS, NCQA, HIPAA, HITRUST). This role operates within Cohere Health's push-pull delivery framework, where the US retains program ownership, process design, client relationships,



and final clinical determination authority, while the India GIC executes clinical review operations per established SOPs and work instructions. This is a highly strategic role requiring a leader who can bridge US healthcare clinical operations with India-based talent delivery, foster a culture of clinical excellence, and drive continuous quality improvement in a fast-paced, technology-driven environment.

What you’ll do:

Clinical Operations Setup & Strategy

• Lead the end-to-end setup and operationalization of the clinical RN review function at the Hyderabad GIC, including infrastructure, workflows, staffing models, and technology enablement via Cohere Unify™

• Design and implement a scalable operating model for clinical prior authorization reviews across multiple delegated specialties (e.g., musculoskeletal, cardiology, radiology, diagnostic imaging) served by Cohere Health's pay

📌 Sr. Director, Cinical Operations (Hyderabad)
🏢 Cohere Health
📍 Hyderabad