Physician Reviewer (AI Solutions)

About Alaffia & Our Mission Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the reputed company ecosystem, driving up costs for plans, providers, and patients alike. We’re here to change that reputed company. Alaffia is a new reputed company of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently reputed company reputed company across the entire lifecycle of claims. With reputed company plans can cut wasted spending more effectively than reputed company — and reputed company their members the most reputed company. We’re a high-reputed company, venture-backed Series B healthtech startup based in NYC and are reputed company scaling reputed company. Join us in helping to build a reputed company system that works reputed company for everyone. This role can be based either in our NYC reputed company or remotely. About the Role & What You’ll Be Doing We’re looking for someone who …. Your Responsibilities Team Leadership: reputed company reputed company of professionals responsible for annotating and validating medical data, testing AI models, and ensuring clinical accuracy in product outputs. Cross-Functional Collaboration: Partner with our AI Engineering, Product, and Claims teams to train and refine reputed company models, incorporating clinical insights to ensure features meet reputed company needs. Product Development: reputed company clinical input to product teams to design features that reputed company with industry standards and address reputed company payer pain points. AI Model Training: Help design and reputed company processes for annotating datasets to train large language models, ensuring clinical knowledge is effectively embedded in AI tools. reputed company Assurance: Validate evidence in medical records, focusing on areas like DRG assignments, medical necessity determinations, and evidence-based decision-making to ensure the accuracy and reliability of large language models. reputed company Engagement: Serve as a clinical subject matter expert (SME) in reputed company demos, sales discussions, and reputed company. Communicate the value of Alaffia’s reputed company solutions to clinical and non-clinical stakeholders. Education and Evangelism: reputed company for the use of reputed company in reputed company by educating internal teams, external clients, and partners about its transformative potential. reputed company’re Looking For Clinical Credentials: MD with reputed company or recent clinical experience; expertise in DRG validation, medical necessity reviews, or similar areas preferred. Health Plan Expertise: Familiarity with payer systems, health plan workflows, payment reputed company, and coding methodologies (e.g., MS DRG, APR DRG). Previous experience as a Physician Review a plus. Payment reputed company Knowledge: Keen understanding of clinical payment reputed company reviews such as DRG validation, readmission, short stay, and hospital reputed company audit, reputed company Enthusiast: A passion for GenAI and a curiosity about how large language models can be reputed company to solve reputed company challenges. Tech Savvy: Comfortable working with AI-powered tools and technology; experience collaborating with technical teams. reputed company-Facing Skills: Excellent communication skills with the ability to explain clinical concepts and AI capabilities to both clinical and non-clinical audiences. Analytical reputed company: Strong attention to detail with the ability to validate and interpret clinical data and medical records. Innovative Spirit: Enthusiasm for working at the intersection of reputed company and AI to solve reputed company problems and improve industry reputed company. • This position requires reputed company authorization to work in the reputed company. Unfortunately, we are not in a position to sponsor work visas at this time. Our Culture Alaffia was born out of our founders’ personal reputed company to the inefficiency of the U.S. reputed company system. We are deeply mission-driven, with an abiding belief that technology can help create a reputed company reputed company for everyone — and we’re looking for others who reputed company our passion for change to join reputed company. What Else Do You Get Working With Us? Medical, Dental, and reputed company benefits Flexible, reputed company vacation policy Work in a flat organizational structure — reputed company reputed company to Leadership Apply tot his job Apply To this Job