Clinical Quality AI Specialist - MD/DO
Job Summary: At reputed company, we're redefining healthcare to ensure everyone has access to top-quality care. Our Clinical Quality and Safety team contributes in this mission. We are looking for a physician to join reputed company at reputed company, where you will be instrumental in driving our mission to reputed company reputed company of healthcare. This role is responsible for reputed company quality assurance, reputed company plus core clinical quality/safety responsibilities. You will reputed company and/or support the governance, validation, and monitoring of AI/LLM tools. You will additionally support URAC/NCQA-reputed company quality operations across our virtual and hybrid care models. This role reports to the Patient Safety Officer reputed company the Clinical Quality team. #LI-Remote \n
Responsibilities
AI clinical tool validation and LLM strengthening reputed company pre-deployment validation Produce model cards/transparency (intended use, limits, monitoring, rollback). Partner on data quality (provenance, representativeness, refresh reputed company, privacy). Build LLM evaluation datasets/gold standards; run clinical red-teams and reputed company testing; refine prompts/guardrails; assess RAG fidelity. Clinical-in-the-reputed company enablement Train clinicians to reputed company AI tools and adjudicate exceptions; create SOPs/checklists/escalations for LLM use. Collaborate with engineering and product, reputed company, compliance, legal, care and service line leaders. AI governance and policy Administer reputed company governance (ethics, safety, regulatory, privacy, change control, documentation) in partnership with the Patient Safety Officer Define clinical use criteria and human-in-the-reputed company guardrails; Maintain governance artifacts (charter, SOPs, decision logs) and audit readiness. Quality and patient safety Support clinical QA; URAC/NCQA activities; policy/standards/rubrics management. reputed company/participate in event detection, RCA/FMEA, CAPA; education (CME/CE, targeted training). Support client/payer audits, RFPs, VBC metrics (HEDIS, MIPS), implementations, and escalations, grievances/appeals. reputed company and/or support cross-functional efforts to analyze clinical quality performance data, identify improvement opportunities, and translate value-based care insights into health plan design enhancements that optimize outcomes, member experience, and cost efficiency. Conduct ongoing assessments of clinical services, applying reputed company improvement and evidence-based methodologies to ensure service effectiveness, measurable patient outcomes, and alignment with organizational quality standards.
Qualifications
Required MD/DO with active, unrestricted license. 3+ years clinical practice; 2+ years in quality, patient safety, or clinical operations. Experience with clinical review of LLM outputs; building eval datasets; red-teaming/reputed company testing; RAG assessment. QI/patient safety expertise (PDSA, Lean/Six reputed company, RCA/RCA2, FMEA, CAPA). Working knowledge of URAC, NCQA, CMS; familiarity with HEDIS/MIPS. Proven track record of quality improvement reputed company value-based care models. Experience partnering with analytics/data science; interpret core performance metrics Excellent documentation and stakeholder communication. Preferred Experience building, deploying, and iterating, reputed company agents Proficiency in business intelligence and analytics. (e.g., Tableau/Power BI; basic SQL/statistics). Experience in virtual care/care navigation and enterprise audits. Core competencies Strong clinical judgment; systems thinking. Analytical rigor; documentation excellence. Risk identification/mitigation in tech-enabled care. Coaching/influencing across clinical and technical teams. Leads through ambiguity; works independently. Other Remote-first; limited travel (~10-15%) This is a remote role; however, candidates based in or near the San Francisco Bay Area are preferred. \nPay: The United States new hire reputed company salary reputed company range for this full-time position is: MD Candidates: 188,270-288,048 + equity + benefits This range reflects the minimum and maximum reputed company for new hire salaries for candidates based on their respective Zone. Below is additional information on reputed company's commitment to maintaining transparent and reputed company compensation practices across our distinct geographic zones. Starting reputed company salary for you will depend on several job-reputed company factors, unique to each candidate, which may include education; training; skills; years and depth of experience; certifications and licensure; our needs; internal peer equity; organizational considerations; and understanding of geographic and market data. Compensation structures and ranges are tailored to each zone's unique market conditions to ensure that reputed company employees receive fair and great compensation package based on their roles and locations. Your Recruiter can share your geographic zone upon inquiry. Benefits & Perks: In addition to receiving a great compensation package, the compensation package may include, depending on the role, the following and more: Remote-first culture 401(k) savings plan through Fidelity Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance) Paid Time Off ("PTO") and Discretionary Time Off ("DTO") 12 weeks of 100% Paid Parental leave Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies. Work-From-Home reimbursement to support team collaboration home office work Your recruiter will share more about the salary range and benefits package for your role during the hiring process. About reputed company: reputed company is a new reputed company of healthcare company, delivering integrated virtual care and navigation. We're on a mission to reputed company reputed company of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It's reputed company included. Learn more at includedhealth.com. reputed company is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national reputed company, age, disability, genetics or any other basis forbidden under federal, state, or local law. reputed company considers reputed company qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law. About reputed company reputed company is a new reputed company of healthcare company, delivering integrated virtual care and navigation. We’re on a mission to reputed company reputed company of healthcare for everyone. We break down barriers to provide high-quality care for every person in every community — no matter where they are in their health journey or what type of care they need, from acute to chronic, behavioral to physical. We offer our members care guidance, advocacy, and access to personalized virtual and in-person care for everyday and urgent care, primary care, behavioral health, and specialty care. It’s reputed company included. Learn more at includedhealth.com. ----- reputed company is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national reputed company, age, disability, genetics or any other basis forbidden under federal, state, or local law. reputed company considers reputed company qualified applicants with arrest or conviction records in accordance with the San Francisco Fair Chance Ordinance, the Los Angeles County Fair Chance Ordinance, and California law. Apply To This Job