Clinical Intelligence

The role

You will use managed care expertise to optimize the quality, accuracy, and efficiency of AI models and clinical workflows. This role involves auditing clinical artifacts, identifying error patterns, and applying AI tools to clinical review.

What you will do

• Audit a high volume of prior authorizations and AI-generated clinical outputs for accuracy and completeness.
• Apply evidence-based clinical reasoning to complex or ambiguous cases.
• Identify recurring error patterns, gaps in clinical guidance, and edge cases.
• Recommend improvements to review standards and workflows.
• Apply AI tools to clinical review and auditing.
• Evaluate AI outputs to increase throughput while maintaining clinical quality.
• Own the quality and timeliness of work and follow issues to resolution.

Required qualifications

• Doctor of Pharmacy (PharmD) degree
• 2–10 years of professional experience
• Hands-on managed care work in prior authorization, utilization management, appeals, or clinical quality at a health plan, pharmacy benefit manager (PBM), or similar organization
• Excellent clinical reasoning
• Strong systems thinking
• Precise written communication and attention to detail
• High ownership and strong execution

Nice to have

• Excitement about working with and applying AI to clinical work
• Intellectual curiosity
• Willingness to experiment
• Judgement to challenge AI outputs

Benefits

• Meaningful equity
• Fully covered medical, vision, and dental insurance
• Memberships for One Medical, Talkspace, Teladoc, and Kindbody
• Unlimited paid time off (PTO)
• 16 weeks of parental leave
• 401K plan setup
• FSA option
• Commuter benefits
• DashPass
• Lunch at the office every day
• Dinner at the office after 6:30 pm

About the company

Forus is building an AI-powered network that connects doctors, pharmacies, payers, and biopharma to accelerate new science to patients. The company is based in New York.