Clinical Operations Specialist, Phoenix

Generator Health • Phoenix, AZ

3d • Onsite

About The Position

As a Clinical Operations Specialist at Generator Health, you will help ensure the accuracy and integrity of the platform’s prior authorization process. This high-autonomy role relies on clinical data expertise, careful review, and the ability to translate clinical documentation into clear findings that support patient access to treatment. You will work closely with the clinical intelligence team across prior authorization, appeals, denial prediction, and related workflows. You will help improve platform accuracy and reliability by reviewing decisions made by AI, third parties, and internal teams.

Requirements

• At least 2 years of hands-on experience in prior authorization, utilization management, clinical care coordination, scribing, or another role involving substantial work with clinical documentation.
• Strong familiarity with medical records and clinical notes, and the ability to interpret them accurately.
• Strong written communication and the ability to translate clinical complexity into clear, actionable findings for non-clinical teams.
• Exceptional attention to detail and accuracy.

Nice To Haves

• Comfort with or a strong interest in collaborating with product, engineering, and data science teammates on building new technologies.

Responsibilities

• Review a live queue of prior authorization cases and ensure decisions meet clinical and operational standards.
• Audit AI outputs, third-party reviews, and internal team decisions for accuracy, consistency, and compliance.
• Flag errors and edge cases and document findings clearly for the clinical intelligence team.
• Collaborate cross-functionally to identify patterns and help refine platform workflows and logic.
• Expand knowledge across medical specialties by working with a diverse range of cases.
• Contribute to improving tools, standards, and processes that support patient access to treatment.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed