Clinical Quality AI Specialist

Responsibilities

• Lead pre-deployment validation for AI clinical tools and strengthen LLM performance
• Build LLM evaluation datasets, run clinical red-teaming, and refine prompts/guardrails
• Develop SOPs, checklists, and escalation paths for clinician oversight of AI tools
• Administer clinical AI governance, including ethics, safety, regulatory, and privacy standards
• Support clinical quality assurance and URAC/NCQA-aligned quality operations
• Lead or participate in event detection, root cause analysis (RCA), and CAPA processes
• Analyze clinical quality performance data to identify improvement opportunities in value-based care

Requirements

• MD/DO with an active, unrestricted medical license
• 3+ years of clinical practice and 2+ years in quality, patient safety, or clinical operations
• Experience with clinical review of LLM outputs, including building evaluation datasets and RAG assessment
• Expertise in Quality Improvement (QI) methodologies such as PDSA, Lean/Six Sigma, or FMEA
• Working knowledge of URAC, NCQA, and CMS regulations, including familiarity with HEDIS/MIPS
• Proven track record of quality improvement within value-based care models
• Strong ability to partner with data science teams and interpret core performance metrics

Preferred Qualifications

• Experience building, deploying, and iterating on clinical AI agents
• Proficiency in business intelligence and analytics tools such as Tableau, Power BI, or SQL
• Experience in virtual care, care navigation, or managing enterprise audits

Benefits

• Remote-first culture with work-from-home reimbursement
• Comprehensive medical, vision, and dental coverage
• 401(k) savings plan through Fidelity
• Paid Time Off (PTO) and Discretionary Time Off (DTO)
• 12 weeks of 100% paid parental leave
• Family building support, including fertility coverage and adoption/surrogacy assistance

About the Company

Included Health is a healthcare company delivering integrated virtual care and navigation. We are on a mission to raise the standard of healthcare for everyone by breaking down barriers to high-quality care across acute, chronic, behavioral, and physical health needs.