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Clinical Quality AI Specialist

2 hours, 3 minutes ago
United States
Full-time
Senior
AI (Artificial Intelligence)
Artificial Intelligence and Machine Learning
LLM Power BI SQL Statistics Tableau
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Included Health

Included Health

Included Health is a healthcare company that provides cost-saving solutions for employers and health plans. They offer virtual care and navigation services, connecting millions with board-certified doctors and specialists for comprehensive and convenie...

Insurance
1K-5K
$106M raised
View All Jobs 26

Description

  • Lead pre-deployment validation and ongoing monitoring of clinical AI and LLM tools.
  • Produce model cards and transparency documentation covering intended use, limitations, monitoring, and rollback.
  • Partner with data, engineering, product, security, compliance, legal, and care leaders on AI quality and governance.
  • Build evaluation datasets and gold standards, and run clinical red-teaming and prompt testing.
  • Refine prompts and guardrails and assess retrieval-augmented generation (RAG) fidelity.
  • Train clinicians to oversee AI tools, adjudicate exceptions, and follow SOPs, checklists, and escalation paths.
  • Stand up and administer clinical AI governance processes, including ethics, safety, regulatory, privacy, and change control.
  • Maintain governance artifacts such as charters, SOPs, decision logs, and audit-ready documentation.
  • Support clinical service-line quality assurance, URAC/NCQA activities, and standards/rubric management.
  • Lead or support event detection, root cause analyses, failure mode analyses, corrective actions, education, audits, and escalation handling.
  • Analyze clinical quality performance data and translate value-based care insights into care model and health plan improvements.
  • Conduct ongoing assessments of clinical services using continuous improvement and evidence-based methodologies.

Requirements

  • Active, unrestricted NP or PA license.
  • 5+ years of clinical practice experience.
  • 2+ years of experience in quality, patient safety, or clinical operations.
  • Experience reviewing LLM outputs, building evaluation datasets, red-teaming prompts, and assessing RAG.
  • Experience with quality improvement and patient safety methodologies such as PDSA, Lean/Six Sigma, RCA/RCA2, FMEA, and CAPA.
  • Working knowledge of URAC, NCQA, and CMS, with familiarity with HEDIS and MIPS.
  • Proven experience improving quality within value-based care models.
  • Experience partnering with analytics or data science teams and interpreting core performance metrics.
  • Strong documentation and stakeholder communication skills.
  • Preferred: proficiency with BI and analytics tools such as Tableau or Power BI, plus basic SQL and statistics.
  • Preferred: experience in virtual care, care navigation, and enterprise audits.
  • Remote-first role with limited travel of 10-15%.

Benefits

  • Base salary target range of $128,130 to $198,610 for PA/NP candidates, plus bonus, equity, and benefits.
  • Remote-first culture.
  • 401(k) savings plan through Fidelity.
  • Comprehensive medical, vision, and dental coverage, including disability insurance.
  • Paid Time Off (PTO) and Discretionary Time Off (DTO).
  • 12 weeks of 100% paid parental leave.
  • Family-building and compassionate leave, including fertility coverage and $25,000 for surrogacy/adoption support.
  • Work-from-home reimbursement to support home office setup and team collaboration.

Interested in this position?

Apply directly on the company website

Apply Now

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