Senior Clinical Quality Manager, AI Clinical Annotation Location:

Remote Job Type:

Full-time Schedule:

M-F 8am-5pm

ET Pay Rate:

$37-$39/hr Minimum Qualifications Active, unrestricted RN license. Bachelor's degree in Nursing (Master's preferred). 3+ years of experience in clinical quality review, utilization management, or prior authorization. Experience reviewing clinical documentation and applying medical necessity criteria. Knowledge of CPT, HCPCS, ICD-10, and payer guidelines. Strong analytical, communication, and facilitation skills. Preferred Qualifications Experience with clinical annotation, healthcare AI/ML, or data-labeling projects. Experience leading calibration sessions and quality assurance initiatives. Familiarity with inter-rater reliability (IRR), precision, recall, and F1 metrics. About the Job The Senior Clinical Quality Manager will oversee the quality and consistency of annotated prior authorization cases used to train AI models. This role conducts quality audits, monitors inter-rater reliability (IRR), leads calibration sessions, provides feedback to clinical annotators, and partners with data science teams to improve annotation quality and AI model performance. Responsibilities Audit annotated cases for accuracy, consistency, and guideline adherence. Monitor annotation quality and IRR metrics. Identify and resolve annotation discrepancies and quality trends. Provide structured feedback and coaching to annotators. Lead clinical calibration sessions and maintain annotation standards. Collaborate with clinical, quality, and data science teams. Update training materials, audit tools, and annotation guidelines. Support onboarding, education, and ongoing quality improvement initiatives. Recommend process improvements based on audit findings and performance data. Medical, dental, and vision insurance are available to qualified candidates who meet eligibility requirements.