Remote Clinical AI Auditor & Quality Lead

Generator Health; Oregon; Hybrid; USD 120.000 - 170.000; Vollzeit

Zusammenfassung

Generator Health is seeking a Clinical AI Specialist to optimize AI model outputs and clinical workflows. You will review all clinical artifacts, apply evidence-based reasoning, and build actionable clinical guidance to improve model accuracy and throughput.

The role emphasizes detailed clinical work, independence, and responsible ownership in a fast-paced environment. Ideal candidates hold a PharmD with 2–10 years in managed care settings (prior auth, UM, appeals, or quality).

Qualifikationen

• PharmD required and 2–10 years of hands-on managed care work (prior auth, UM, appeals, or clinical quality) in health plans, PBMs, or similar.
• Excellent clinical reasoning to synthesize medical records, payer criteria, and evidence; ability to work through ambiguity.
• Strong systems thinking to identify recurring patterns and root causes; improve how cases are reviewed.
• Precise written communication to provide structured feedback with clinical significance and necessary corrections.
• High ownership and strong execution; work independently and deliver accurate work at high volume.
• Excitement about applying AI to clinical work with curiosity and professional judgment.

Aufgaben

• Audit a high volume of prior authorizations and AI-generated outputs for accuracy and alignment with records and payer criteria.
• Apply evidence-based clinical reasoning to complex cases and help scale expertise.
• Identify recurring error patterns and edge cases; investigate causes and improve review standards and workflows.
• Apply AI tools to clinical review, critically evaluate outputs, and maintain quality while increasing throughput.
• Own the quality and timeliness of your work and see issues through to resolution.

Kenntnisse

Clinical reasoning

Systems thinking

Written communication

Ownership & execution

AI familiarity

Ausbildung

Doctor of Pharmacy (PharmD)

Jobbeschreibung

Generator Health is seeking a Clinical AI Specialist to optimize AI model outputs and clinical workflows. You will review all clinical artifacts, apply evidence-based reasoning, and build actionable clinical guidance to improve model accuracy and throughput.

The role emphasizes detailed clinical work, independence, and responsible ownership in a fast-paced environment. Ideal candidates hold a PharmD with 2–10 years in managed care settings (prior auth, UM, appeals, or quality).