Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time)
Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time) Rate $45/hour (depending on experience) Schedule Part-time, fully remote Company Quantile Health – AI-Powered Insights for Life Science Quantile 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 Role
We’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 Process
- Take-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 questions Responsibilities
- Review payer PA policy documents for specialty medications. Interpret coverage criteria including Step therapy sequences, Prescriber and site-of-care restrictions etc
- Translate policy language into standardized, structured data fields
- Flag ambiguous, conflicting, or unclear policy language
- Maintain high accuracy and consistency across large document batches
- Communicate edge cases and clarifications via Slack Required Qualifications
- Bachelors degree, Masters degree in Pharmacy, Pharmacy intern, or PharmD student
- 1+ 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 biologics
- Proven ability to interpret payer policy language independently
- Exceptional attention to detail
- Comfort with repetitive, structured work Preferred Qualifications
- PharmD
- Prior responsibility for PA interpretation or benefit determinations
- Experience training or QA’ing other reviewers How We Work
- Fully 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 internally
- All communication via Slack Apply To this Job