Clinical Intelligence Specialist

 Posted 6 days ago
     
 $41600 - $104K per year
  
2-5 years experience
Apply Now

Please mention DailyRemote when applying

AI Summary

The specialist will review prior authorization cases and audit AI and internal decisions to ensure clinical and operational accuracy. They will collaborate cross-functionally to refine workflows and logic to improve patient access to treatment.

About the role

As a Clinical Intelligence Specialist at Generator Health, you will play a critical role in ensuring the accuracy and integrity of our system’s prior authorization process. You'll bring your expertise in clinical data understanding to catch errors, and uphold the standards that our patients and providers depend on.

This is a high-autonomy role where your attention to detail and ability to read, understand, and translate clinical data into results directly impacts patient access to treatment. Tens of thousands of patients move through our platform every week. You will work closely with our clinical intelligence team to support prior authorization, appeals, denial prediction and more. Your contributions will help us continuously improve the accuracy and reliability of our platform, whether decisions were made by AI, a third party, or our internal team.

If you join, you will:

  • Review a live queue of prior authorization cases coming through the platform, ensuring every decision meets clinical and operational standards

  • Audit AI outputs, third party reviews, and internal team decisions for accuracy, consistency, and compliance

  • Flag errors and edge cases, documenting findings clearly for the clinical intelligence team

  • Collaborate cross-functionally to surface patterns and help refine the workflows and logic that power our platform

  • Expand your knowledge across medical specialties as you work across a diverse range of cases

  • Contribute to improving the tools, standards, and processes that support patient access to treatment

We’ll be most excited if you have:

  • 2+ years of hands-on experience in prior authorization, utilization management, clinical care coordination, scribing, or other roles that involve deep work with clinical documentation

  • Strong familiarity with medical records and clinical notes, and comfort interpreting them accurately

  • Strong written communication, with an ability to translate clinical complexity into clear, actionable findings for non-clinical teams

  • Exceptional attention to detail and accuracy

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

Our salary ranges are based on a number of factors, including qualifications, experience level, and geography.

Generator Health is an equal opportunity employer and does not discriminate on the basis of race, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition, or any other basis protected by law.

Similar Jobs

See all Remote Healthcare jobs →

Personalize your Remote Job Search in 3 Easy Steps!

Discover remote opportunities in Healthcare

Answer easy questions

Answer easy questions

200,000+ jobs across 15+ categories

Get your best job matches

Get your best job matches

Only hand-screened, legit jobs

Find a remote job faster

Find a remote job faster

No ads, scams, or junk

I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!

Sarah J. — Sarah J. · Marketing Manager ★★★★★ Verified