Operations Specialist, Phoenix at Generator Health · LumiJobs
On Site
$44k
H1B: no
Generator Health Clinical Operations Specialist at Generator Health ensuring accuracy and integrity of prior authorization processes. Review clinical data and audit AI and third-party decisions to support patient access to treatment.
Responsibilities
As a Clinical Operations Specialist at Generator Health, you will play a critical role in ensuring the accuracy and integrity of our system’s prior authorization process. You'll bring your expertise in clinical data understanding to catch errors, and uphold the standards that our patients and providers depend on.
This is a high-autonomy role where your attention to detail and ability to read, understand, and translate clinical data into results directly impacts patient access to treatment. Tens of thousands of patients move through our platform every week. You will work closely with our clinical intelligence team to support prior authorization, appeals, denial prediction and more. Your contributions will help us continuously improve the accuracy and reliability of our platform, whether decisions were made by AI, a third party, or our internal team.
If you join, you will:
Review a live queue of prior authorization cases coming through the platform, ensuring every decision meets clinical and operational standards
Audit AI outputs, third party reviews, and internal team decisions for accuracy, consistency, and compliance
Flag errors and edge cases, documenting findings clearly for the clinical intelligence team
Collaborate cross-functionally to surface patterns and help refine the workflows and logic that power our platform
Expand your knowledge across medical specialties as you work across a diverse range of cases
Contribute to improving the tools, standards, and processes that support patient access to treatment
We’ll be most excited if you have:
2+ years of hands-on experience in prior authorization, utilization management, clinical care coordination, scribing, or other roles that involve deep work with clinical documentation
Strong familiarity with medical records and clinical notes, and comfort interpreting them accurately
Qualification
Ability to master new
Required
Experience in analytical problem-solving, operational rigor, and outcome ownership
Ability to deal with ambiguous problems and resolve them effectively
Ability to master new, complex technology tools quickly and work with data