Included Health · 2 days ago
Clinical Quality AI Specialist
United States
Full-time
Remote
Mid, Senior Level
$128K/yr - $199K/yr
5+ years expIncluded Health is a new kind of healthcare company, delivering integrated virtual care and navigation. They are looking for an advanced practitioner to drive clinical AI quality assurance and oversee governance, validation, and monitoring of AI tools while supporting quality operations across their care models.
Health CareHospitalMedicalmHealth
Responsibilities
Lead pre-deployment validation
Produce model cards/transparency (intended use, limits, monitoring, rollback)
Partner on data quality (provenance, representativeness, refresh cadence, privacy)
Build LLM evaluation datasets/gold standards; run clinical red-teams and prompt testing; refine prompts/guardrails; assess RAG fidelity
Train clinicians to oversee AI tools and adjudicate exceptions; create SOPs/checklists/escalations for LLM use
Collaborate with engineering and product, security, compliance, legal, care and service line leaders
Stand up/administer clinical AI governance (ethics, safety, regulatory, privacy, change control, documentation) in partnership with the Patient Safety Officer
Define clinical use criteria and human-in-the-loop guardrails
Maintain governance artifacts (charter, SOPs, decision logs) and audit readiness
Support clinical service-line QA; URAC/NCQA activities; policy/standards/rubrics management
Lead/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
Lead 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 continuous improvement and evidence-based methodologies to ensure service effectiveness, measurable patient outcomes, and alignment with organizational quality standards
Qualification
Required
NP or PA with active, unrestricted license
5+ years clinical practice; 2+ years in quality, patient safety, or clinical operations
Experience with clinical review of LLM outputs; building eval datasets; red-teaming/prompt testing; RAG assessment
QI/patient safety expertise (PDSA, Lean/Six Sigma, RCA/RCA2, FMEA, CAPA)
Working knowledge of URAC, NCQA, CMS; familiarity with HEDIS/MIPS
Proven track record of quality improvement within value-based care models
Experience partnering with analytics/data science; interpret core performance metrics
Excellent documentation and stakeholder communication
Preferred
Proficiency in business intelligence and analytics. (e.g., Tableau/Power BI; basic SQL/statistics)
Experience in virtual care/care navigation and enterprise audits
Benefits
Remote-first culture
401(k) savings plan through Fidelity
Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
Full suite of Included Health telemedicine (e.g. behavioral health, urgent care, etc.) and health care navigation products and services offered at no cost for employees and dependents
Generous Paid Time Off ("PTO") and Discretionary Time Off (“DTO”)
12 weeks of 100% Paid Parental leave
Up to $25,000 Fertility and Family Building Benefit
Compassionate Leave (paid leave for employees who experience a failed pregnancy, surrogacy, adoption or fertility treatment)
11 Holidays Paid with one Floating Paid Holiday
Work-From-Home reimbursement to support team collaboration and effective home office work
24 hours of Paid Volunteer Time Off (“VTO”) Per Year to Volunteer with Charitable Organizations
Company
Included Health
Included Health provides a combination of virtual care, navigation, and communities-based healthcare services.
1001-5000 employees
H1B Sponsorship
Included Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (12)
2024 (9)
2023 (8)
2022 (6)
Funding
Current Stage
Late StageTotal Funding
$344MKey Investors
The Carlyle GroupGreylockVenrock
2020-09-09Series E· $175M
2018-05-02Series D· $66M
2017-01-01Series Unknown
Leadership Team
Owen Tripp
Chief Executive Officer
Wade Chambers
CTO & SVP of Engineering
Recent News
Company data provided by crunchbase