Prior Authorization Clinical Labeling Specialists (Pharmacists, Nurses, PAs & Pharmacy Technicians)

Apex Data Sciences; United States; On-site; USD 41,000 - 83,000; Part time

Job summary

Apex Data Sciences is seeking experienced Clinical Labeling Specialists to support a leading AI lab focused on improving prior authorization workflows in real‑world care settings for diverse health plans.

This contract runs 6–8 weeks with potential extension; you’ll answer medication‑related clinical questions, review AI responses, annotate and calibrate data, and help ensure patient safety and treatment accuracy in evolving AI systems.

Qualifications

• Hands-on prior authorization experience required.
• Active license in PharmD/RPh/NP/RN/PA.
• Strong understanding of medications, contraindications, and drug interactions.
• Excellent clinical judgment and attention to detail.
• Ability to evaluate medical content for clinical accuracy and safety.
• Willing to work 30–40 hours per week and complete a take-home assessment.

Responsibilities

• Answer medication-related clinical and prior authorization questions using patient context, supporting documentation, payer criteria, and labeling guidelines.
• Evaluate medication requests against health plan criteria and determine whether the criteria are met.
• Review AI-generated clinical responses for accuracy, safety, completeness, and clarity.
• Correct inaccurate or incomplete responses and provide structured annotations and feedback.
• Identify and elevate cases involving ambiguous clinical information or potential patient safety concerns.
• Apply clinical quality standards consistently while participating in calibration and quality review sessions.

Skills

Prior authorization experience

Clinical knowledge

Attention to detail

Clinical judgment

Education

Active clinical license (PharmD/RPh/NP/RN/PA)

Job description

Compensation: $30–$60/hour (based on clinical experience)

Help Build the Next Generation of Clinical AI

We're seeking experienced Clinical Labeling Specialists to support a leading AI Lab focused on improving prior authorization workflows.

If you have hands‑on prior authorization experience, ideally evaluating whether a medication request meets a health plan's coverage criteria, and enjoy applying your clinical expertise to ensure accuracy, safety, and quality, we'd love to hear from you.

Prior authorization experience is required.

In this role, you'll work alongside cutting‑edge AI systems by answering medication‑related clinical questions, reviewing AI‑generated responses, and helping improve the quality of healthcare AI used in real‑world clinical workflows.

This is an initial 6–8 week contract with the potential for extension. High-performing contributors may be considered for longer-term opportunities based on project needs and performance. We are looking for people interested in a sustained, ongoing engagement.

What You'll Do

• Answer medication‑related clinical and prior authorization questions using patient context, supporting documentation, payer coverage criteria, and labeling guidelines.
• Evaluate medication requests against health plan criteria and determine whether the criteria are met, drawing on your hands‑on prior authorization experience.
• Review AI‑generated clinical responses for accuracy, safety, completeness, and clarity.
• Correct inaccurate or incomplete responses and provide structured annotations and feedback.
• Identify and elevate cases involving ambiguous clinical information or potential patient safety concerns.
• Apply clinical quality standards consistently while participating in calibration and quality review sessions.

Who We're Looking For

We're looking for clinical professionals with hands‑on prior authorization experience in one of the following backgrounds:

• Licensed Pharmacist (PharmD/RPh)
• Nurse Practitioner (NP), Registered Nurse (RN), or Physician Assistant (PA)
• Certified Pharmacy Technician with direct prior authorization and/or benefit verification experience

Required Qualifications

• Hands‑on prior authorization experience (required): direct, recent experience working prior authorization cases, ideally on the payer/coverage side reviewing medication requests against plan criteria.
• Active, current license or certification in one of the roles listed above.
• Strong understanding of medications, prescriptions, contraindications, and drug interactions.
• Excellent clinical judgment and attention to detail.
• Ability to evaluate medical content for clinical accuracy and patient safety.
• Comfortable working with detailed guidelines and structured annotation tasks.
• Available for 30–40 hours per week during the project.
• Willing to complete a 2–3 hour take‑home assessment as part of the selection process. The assessment will be representative of the work you'll do on the project, so you can gauge whether it's a good fit.

Preferred Experience

• Benefit and insurance verification
• Pharmacy operations
• Clinical documentation
• Clinical quality assurance
• AI data annotation or model evaluation
• Clinical content review
• 340B or medication assistance programs

Selection process:

Strong performers on the take‑home assessment will be invited to a final round of interviews to go over the case and your other experience.

If you're passionate about improving healthcare through AI while applying your clinical expertise to meaningful real‑world use cases, we'd love to hear from you.