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Founder / Operator·RCM

Siva Namasivayam

CEO and Co-Founder at Cohere Health

Westport, CT, USA (Cohere Health HQ: Boston, MA)

SN
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Why they matter

Two-exit healthcare founder (SCIO sold to EXL for $236.5M) now running Cohere Health, the Temasek-backed AI prior-authorization platform, with rare operator depth in payer utilization management.

Background

Siva Namasivayam is co-founder and CEO of Cohere Health, a Boston-based AI platform transforming prior authorization and utilization management for health plans. This is his third healthcare venture: he previously founded SCIO Health Analytics, growing it from zero to $90M revenue and 1,200 employees before selling to EXL in 2018 for $236.5M. Earlier roles include SVP/chief revenue officer at EDS/MphasiS and SVP of payer services at Dell, with an MS in computer science (Pittsburgh) and an MBA (Michigan).

Notable deals

  • 2025
    Raised $90M Series C for Cohere Health led by Temasek, bringing total funding to $200M
  • 2024
    Raised $50M equity round for Cohere Health led by Deerfield Management to scale AI-driven prior authorization
  • 2018
    Sold SCIO Health Analytics, which he founded and grew to $90M revenue, to EXL for $236.5M

Call-prep brief

Background

  • Third-time healthcare founder; co-founded Cohere Health in 2019 and serves as CEO.
  • Founded SCIO Health Analytics in 2007, scaled it to $90M revenue and 1,200+ employees (Inc. 5000 seven years running), sold to EXL in 2018 for $236.5M.
  • Prior operating roles: SVP/CRO at EDS/MphasiS, SVP payer services at Dell, engineer at Intel. MS computer science (Pittsburgh), MBA (Michigan).

Current focus

  • Scaling Cohere's AI-powered utilization management platform beyond prior authorization into broader health-plan clinical decision-making, funded by a $90M Temasek-led Series C (May 2025; $200M total raised).
  • Deep payer relationships; Deerfield, Define Ventures, Flare Capital, Longitude, and Polaris are on the cap table.

What they care about

  • Positioning AI as clinician-augmenting, not care-denying — 'right care at the right time' framing.
  • Value-based care economics and plan–provider collaboration.

Potential sensitivities

  • Prior authorization is under regulatory and public scrutiny (CMS rules, denial-of-care headlines); avoid framing Cohere as a denial engine.
  • Well capitalized as of mid-2025 — a pure funding pitch will land flat; strategic angles (M&A, payer channel, RCM adjacencies) are stronger.

Questions to ask

  1. Which adjacent utilization-management use cases is the Series C funding actually unlocking first?
  2. How is Cohere navigating CMS prior-authorization reform — tailwind or margin pressure?
  3. What would make an acquisition or strategic partner more attractive than an eventual IPO path?

Outreach draft

Subject
Cohere's next chapter in clinical decisioning
Hi Siva, I've followed Cohere Health since the Temasek-led Series C — expanding from prior authorization into broader clinical decision-making is exactly the shift we think the payer market is underestimating. Your track record building and exiting SCIO gives you a rare vantage point on where utilization management is heading. We're investors focused on healthcare RCM and payer technology, and I'd value 30 minutes to hear how you see the space consolidating — and to share where we're looking to partner with category leaders. Would a brief call in the next couple of weeks work? Best regards, [Name]

Linked companies

Sources