Cohere Health
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Location
Headquarters: Boston, Massachusetts, United States, North America
Region: Massachusetts
Country: US
Continent: North America
About
Cohere Health transforms utilization management and prior authorization for health plans and providers by offering scalable, clinically guided AI-powered solutions that improve efficiency, decision accuracy, and patient access. The company provides a unified platform and services for in-house, delegated, and API-based utilization management, as well as payment integrity, across diverse specialties. Headquartered in Portsmouth, New Hampshire, Cohere targets health plans and providers to streamline care decisions, automate audits, and optimize value-based care. Its offerings emphasize specialty-specific workflows, transparent decision-making, and actionable clinical insights to reduce administrative burden and improve outcomes.
Cohere Health provides AI-powered clinical intelligence and prior authorization solutions for health plans and providers. Its platform automates utilization management and payment integrity to streamline care decisions and reduce administrative burdens. The company serves the healthcare industry by aligning physicians and insurers on evidence-based care paths.
Cohere Health, Inc.
2019
for_profit
active
Industries
Primary Industry: Business Services
Categories
Funding & Financials
Series C
106100000
50m-100m
private
Investors
Founders
Duncan Reece
Siva Namasivayam
Leadership
Siva Namasivayam — Chief Executive Officer
Sohail Djariri — Chief Revenue Officer
Kristen Carucci — Chief Financial Officer
Samantha Rideout — Product Marketing Lead
Robert Shepardson — Chief Financial Officer
Niall O'Connor — Chief Technology Officer
Tammi Pirri — Chief People Officer
Alex Brayton — Senior Director, Strategic Accounts
Michael Greeley — board_member
William H. Shrank, M.D. — board_member
Gary L. Gottlieb — board_member
Technology Stack
Products
Cohere Unify™ platform: A clinical intelligence platform that collects and analyzes patient data to evaluate prior authorization requests and generate clinical decisions or recommendations.
Cohere Complete™ Outsourced Utilization Management (UM): A fully delegated utilization management service combining AI technology and clinical staff to manage prior authorizations across key specialties for health plans.
Cohere utilization management - In-House utilization: A clinical intelligence platform that supports health plans’ internal utilization management teams to automate and improve prior authorization processes.
Cohere utilization management - Delegated utilization: A fully delegated utilization management service combining AI and clinical expertise to manage prior authorizations for select specialties on behalf of health plans.
Cohere Connect™ Prior Authorization APIs: A set of APIs that enable health plans to automate and comply with CMS-0057-F prior authorization interoperability requirements.
Cohere Surface: An agentic-AI-powered claims data mining solution that provides transparent rule logic and overpayment insights for health plans.
Funding rounds
Series C · $90M · (2025-05-14) · Lead: Temasek Holdings
Series C · $50M · (2024-02-01) · Lead: Deerfield Management
Series B · $36.1M · (2021-04-13) · Lead: Polaris Partners