💼 About This Role

You'll review clinical documentation and model-generated authorization outcomes for specialty pharmaceutical referrals at a health tech startup. Your core impact is ensuring payer criteria are accurately applied to reduce patient delays. This fully-remote role lets you leverage your infusions/SP experience in a new, AI-powered context.

🎯 What You'll Do

• Review model outputs to improve criteria determinations
• Flag incorrect determinations with structured feedback
• Compare documentation against payer coverage policies
• Analyze source materials to validate qualification logic

📋 Requirements

• Hands-on infusions/SP experience in intake, documentation review, case management, or clinical review
• Confident identifying when documentation meets or fails payer requirements
• Comfortable reviewing insurance coverage policies and applying them to real-world cases
• Highly organized, detail-focused, and confident making policy-based decisions

✨ Nice to Have

• 4+ years in infusions/SP, especially intake, documentation review, case management, or clinical review
• Tech-savvy and comfortable using AI tools
• Familiarity with Medicare, Medicaid, and commercial payer guidelines for infusions/SP

🎁 Benefits & Perks

• 🏖️ Unlimited PTO
• 🏠 Fully-Remote Flexibility
• 🏥 100% paid employee health benefit options
• 💰 Employer-funded 401(k) match
• 👶 Competitive parental leave

📨 Hiring Process

Estimated timeline: 2-3 weeks · AI estimate

1. 1Recruiter Screen· 30 min
2. 2Hiring Manager Interview· 45 min
3. 3Technical/Clinical Assessment· 60 min