Clinical Intelligence

About the Role

As a member of the Clinical Intelligence Review team at Generator Health, you will use your managed care expertise to optimize the quality, accuracy, and efficiency of our AI models and clinical workflows. You will own the review of all clinical artifacts our system produces - using cutting-edge AI tooling to build a view of accuracy that stitches together clinical context, payer requirements, and regulatory compliance. Using your clinical judgement and nuanced auditing, you will help build the clinical guidance our models and clinical teams use to continuously improve our system’s outputs.

This is a hands-on role centered on clinical review, structured feedback, and iterative improvement. You’ll look beyond individual cases to identify recurring problems, synthesize learnings into clinical guidance, and assess whether changes improve quality and throughput. We’re looking for someone who thrives in detailed clinical work and is excited to use AI to solve one of the most complex and time-consuming problems in healthcare operations.

This is a demanding role with a high level of autonomy and responsibility. You will be expected to act like an owner: prioritize effectively, surface problems early, and follow through until they’re resolved. If you are low-ego, hungry to learn, and motivated by consequential clinical work, we want to hear from you.

If You Join, You Will

• Audit a high volume of prior authorizations and AI-generated clinical outputs for accuracy, completeness, and alignment with the medical record and applicable payer criteria.
• Apply evidence-based clinical reasoning to complex or ambiguous cases, distinguish clinically meaningful errors from minor issues, and help build a system that scales your expertise.
• Identify recurring error patterns, gaps in clinical guidance, and edge cases; investigate their underlying causes and recommend improvements to review standards and workflows.
• Apply AI tools to clinical review and auditing, critically evaluate their outputs, and identify ways to increase throughput while maintaining a high standard of clinical quality.
• Own the quality and timeliness of your work, meet review expectations, and follow issues through to resolution.

We’re Looking for You If You Have

• A Doctor of Pharmacy (PharmD) degree and 2-10 years of professional experience, including hands-on managed care work in prior authorization, utilization management, appeals, or clinical quality at a health plan, pharmacy benefit manager (PBM), or similar organization.
• Excellent clinical reasoning: you can synthesize medical records, medication histories, payer criteria, and clinical evidence, work through ambiguity, and clearly explain a defensible conclusion.
• Strong systems thinking: you look beyond individual errors to recognize recurring patterns, identify root causes, and improve how similar cases are reviewed.
• Precise written communication and attention to detail, with the ability to provide structured feedback that makes the issue, its clinical significance, and the needed correction clear.
• High ownership and strong execution: you work independently, prioritize effectively, and reliably deliver accurate work at high volume.
• Excitement about working with and applying AI to clinical work, paired with intellectual curiosity, a willingness to experiment, and the judgement to challenge AI outputs and revise your own conclusions when the evidence warrants it.

Additional information

This is a list of ideal qualifications for this position. If you don't meet every single one of them, you should still consider applying! We’re excited to work with people from underrepresented backgrounds, and we encourage people from all backgrounds to apply.

Working with US

Forus is based in New York, with our full team working out of a beautiful and spacious office in SoHo.

We run as a high-trust environment with high autonomy, which requires that everyone is fully competent and operates in line with our principles:

• Do the math. Be rigorous, assume nothing. Break problems down and reason from the ground up. Stay open to changing your mind.
• Resourceful optimism. Assume problems are solvable. Be audacious. Resist false constraints and push beyond the obvious before deciding.
• Spit it out. Speak directly, invite critique, avoid equivocation. We want right answers, not comfortable ones. All killer, no filler.
• Raise the bar. Hold a high standard for your pace and execution, and elevate the performance of the team around you. Mamba mentality.
• Fight for users. Start with users’ realities, not ours. Resist optimizing for internal convenience over user outcomes.

Pay and benefits

We provide competitive compensation with meaningful equity (for full-time employees). Everyone who joins will be a major contributor to our success, and we reflect this through ownership and pay.

We also provide rich benefits to ensure you can focus on creating impact (for full-time employees):

• Fully covered medical, vision, and dental insurance.
• Memberships for One Medical, Talkspace, Teladoc, and Kindbody.
• Unlimited paid time off (PTO) and 16 weeks of parental leave.
• 401K plan setup, FSA option, commuter benefits, and DashPass.
• Lunch at the office every day and Dinner at the office after 6:30 pm.

Our salary ranges are based on paying competitively for our company’s size and industry, and are one part of the total compensation package that also includes equity, benefits, and other opportunities at Forus (for full-time employees). Individual pay decisions are ultimately based on a number of factors, including qualifications for the role, experience level, skillset, geography, and balancing internal equity.