Clinical AI Specialist (Remote)

Generator Health

2d • Remote

About The Position

As a member of the Clinical AI Specialist team at Generator Health, this role uses managed care expertise to optimize the quality, accuracy, and efficiency of AI models and clinical workflows. The specialist reviews clinical artifacts produced by the system, using AI tools to assess accuracy in light of clinical context, payer requirements, and regulatory compliance. Clinical judgment and nuanced auditing help develop guidance used by models and clinical teams to improve system outputs.

This hands-on role focuses on clinical review, structured feedback, and iterative improvement. The specialist identifies recurring problems beyond individual cases, synthesizes findings into clinical guidance, and assesses whether changes improve quality and throughput. The position involves substantial autonomy and responsibility, with expectations to prioritize effectively, surface problems early, and follow them through to resolution.

Requirements

• Doctor of Pharmacy (PharmD) degree.
• 2–10 years of professional experience, including hands-on managed care work in prior authorization, utilization management, appeals, or clinical quality at a health plan, pharmacy benefit manager (PBM), or similar organization.
• Excellent clinical reasoning, including the ability to synthesize medical records, medication histories, payer criteria, and clinical evidence; work through ambiguity; and clearly explain a defensible conclusion.
• Strong systems thinking, including the ability to recognize recurring patterns, identify root causes, and improve how similar cases are reviewed.
• Precise written communication and attention to detail, with the ability to provide structured feedback that clearly explains the issue, its clinical significance, and the needed correction.
• Ability to work independently, prioritize effectively, and reliably deliver accurate work at high volume.
• Excitement about applying AI to clinical work, intellectual curiosity, willingness to experiment, and judgment to challenge AI outputs and revise conclusions when evidence warrants it.

Responsibilities

• Audit a high volume of prior authorizations and AI-generated clinical outputs for accuracy, completeness, and alignment with the medical record and applicable payer criteria.
• Apply evidence-based clinical reasoning to complex or ambiguous cases, distinguish clinically meaningful errors from minor issues, and help build a system that scales clinical expertise.
• Identify recurring error patterns, gaps in clinical guidance, and edge cases; investigate underlying causes and recommend improvements to review standards and workflows.
• Apply AI tools to clinical review and auditing, critically evaluate their outputs, and identify ways to increase throughput while maintaining high clinical quality.
• Own the quality and timeliness of work, meet review expectations, and follow issues through to resolution.

What This Job Offers

• Job Type: Full-time
• Education Level: Ph.D. or professional degree