Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time) at Quantile Health

Company: Quantile Health – AI-Powered Insights for Life ScienceQuantile Health is a New York-based, fast growing AI agent startup on a mission to expand patient access to life-changing medicines while cutting commercial research costs for the life science industry.About the RoleWe’re seeking a part-time Prior Authorization (PA) specialist to work with our AI research teams to improve our access agent. This role focuses on identifying patient access gaps and improving model accuracy, and requires hands-on experience interpreting PA requirements in specialty pharmacy, hub services, or utilization management.This is not a patient-facing role and does not involve submitting PA requests.Our Interview ProcessTake-Home Exercise (30–45 minutes): You’ll complete a short classification task with instructions. We’ll evaluate it based on speed and accuracy.Conversation (30-minute Google Meet): If selected, you’ll meet with one of our AI researchers to walk through your approach and findings, and answer any of your questionsResponsibilitiesReview payer PA policy documents for specialty medications. Interpret coverage criteria including: Step therapy sequences, Prescriber and site-of-care restrictions etcTranslate policy language into standardized, structured data fieldsFlag ambiguous, conflicting, or unclear policy languageMaintain high accuracy and consistency across large document batchesCommunicate edge cases and clarifications via SlackRequired QualificationsBachelors degree, Masters degree in Pharmacy, Pharmacy intern, or PharmD student1+ years of direct experience interpreting PA requirements in: Specialty pharmacy; Hub services; Utilization management teams within payer organizations or reimbursement and benefit verification teams.Strong familiarity with specialty drugs and biologicsProven ability to interpret payer policy language independentlyExceptional attention to detailComfort with repetitive, structured workPreferred QualificationsPharmDPrior responsibility for PA interpretation or benefit determinationsExperience training or QA’ing other reviewersHow We WorkFully remote and async-friendly, with the flexibility to work weekends or outside of standard 9–5 hours whenever it fits your schedule.Accuracy and turnaround time tracked internallyAll communication via Slack

Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time)

Emma

Responsibilities

Skills wanted:

Language(s) required:

Yutong

About Quantile Health:

quantilehealth.com/

Admin access needed