Clinical and Health Specialist
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Job Description
Clinical healthcare SMEs authoring high-fidelity tasks and evaluating medical records for Donato Technologies. Supporting benchmark quality, safety, documentation, and clinical reasoning across specialties.
Responsibilities:
- Author and evaluate high-fidelity clinical tasks, long-chart scenarios, workplace simulations, and benchmark evaluation rubrics
- Develop high-difficulty clinical tasks, realistic workplace cases, gold-standard answers, and evaluation criteria within the assigned discipline
- Evaluate fragmented, multi-encounter records and identify clinically meaningful trends, contradictions, omissions, risks, and required actions
- Assess outputs for clinical accuracy, practicality, evidence alignment, patient safety, and appropriateness for the relevant care setting
- Apply evaluation criteria to assess clinical reasoning, terminology, documentation quality, regulatory alignment, payer accuracy, and patient-safety implications
- Review specialty tasks involving rehabilitation, swallow and diet-texture recommendations, medical necessity, prior authorization, claims and denials, nutrition support, diabetes management, psychosocial safety, infection prevention, coding and CDI, medication safety, addiction treatment, emergency decision-making, or EMS handoffs
- Review and calibrate pod members’ work, resolve edge-case ambiguities, identify rubric inconsistencies, and maintain day-to-day quality standards on the Senior Track
- Evaluate cross-functional tasks requiring coordination across physicians, nurses, therapists, pharmacists, social workers, dietitians, coders, case managers, payers, laboratory professionals, or emergency personnel
- Incorporate calibration feedback, revise task content and solutions, and participate in multiple critique cycles
- Escalate clinical, regulatory, or rubric ambiguities to the Functional SME Lead and support consistent decision-making on the Senior Track
- Maintain quality across a designated Clinical & Health pod and support rubric development as a Senior Specialist / Functional Lead
Requirements:
- Approximately 3 to 15+ years of demonstrable professional experience in one or more relevant Clinical & Health disciplines
- Current or recent practice within the last three years in the applicable clinical, hospital, payer, laboratory, behavioral-health, revenue-cycle, or quality setting
- Active professional licensure, board certification, or recognized credential appropriate to the discipline
- Strong clinical reasoning, chart-review, documentation, and written communication skills
- Ability to interpret fragmented medical records, reconcile conflicting information, identify missing or unsafe actions, and produce clinically defensible conclusions
- High attention to detail regarding patient safety, clinical terminology, medical necessity, coding accuracy, payer requirements, regulatory standards, and documentation gaps
- Ability to work within structured review cycles, standardized rubrics, and fast-paced calibration environments
- Familiarity with US clinical guidelines, payer policies, regulatory requirements, and healthcare workflows is preferred
- Bachelor’s degree, graduate degree, professional degree, or equivalent practical experience in a relevant healthcare discipline
- Active professional license, board certification, or recognized industry credential where applicable
- Experience in clinical practice, healthcare operations, medical review, AI evaluation, data annotation, content review, quality assurance, clinical documentation, or a related analytical role is preferred
- Prior experience reviewing expert work, creating clinical education content, developing assessment materials, or participating in quality-improvement programs is advantageous
- 4 hours of PST overlap required
- Relevant discipline-specific qualifications may include PT, OT, SLP, RN, RD/RDN, LCSW, PharmD, MD, DO, or other applicable professional license
- Relevant specialist credentials may include BCPS, BCCCP, CIC, CPHQ, CPPS, CCS, CPC, CDIP, CCDS, CDCES, ABEM, ABPN, ABPM, or equivalent
Benefits:
- Flexible Spending Account with pre-tax benefit for Medical and Dependent care
- Paperless pay statement with online paycheck management
- Monthly pay for contract employees
- Full-time or part-time commitment options: 40h or 20h per week
- Remote work
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