Clinical Operations Specialist

Key Responsibilities:

• Review a live queue of prior authorization cases to ensure each 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.

Qualifications:

• 2+ years of hands-on experience in prior authorization, utilization management, or clinical care coordination.
• Strong familiarity with medical records and clinical notes, and comfort interpreting them accurately.
• Exceptional attention to detail and accuracy.

Work Environment:

• This is a remote full-time hourly position with telecommute arrangement.
• Must reside in one of the listed US states to be considered.
• You will collaborate closely with product, engineering, and data science teams in a high-autonomy role.