Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time)
Quantile Health
Location
United States, Remote
Employment Type
Part time
Location Type
Remote
Department
Utilization Management & Authorization
Compensation
- $45 per hour
Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time)
Rate: $45/hour (depending on experience)
Schedule: Part-time, fully remote
Company: Quantile Health – AI-Powered Insights for Life Science
Quantile Health is a New York-based, fast growing AI agent startup on a mission to expand patient access to life-changing medicines while cutting commercial research costs for the life science industry.
About the Role
We’re seeking a part-time Prior Authorization (PA) specialist to work with our AI research teams to improve our access agent. This role focuses on identifying patient access gaps and improving model accuracy, and requires hands-on experience interpreting PA requirements in specialty pharmacy, hub services, or utilization management.
This is not a patient-facing role and does not involve submitting PA requests.
Our Interview Process
Take-Home Exercise (30–45 minutes): You’ll complete a short classification task with instructions. We’ll evaluate it based on speed and accuracy.
Conversation (30-minute Google Meet): If selected, you’ll meet with one of our AI researchers to walk through your approach and findings, and answer any of your questions
Responsibilities
Review payer PA policy documents for specialty medications. Interpret coverage criteria including: Step therapy sequences, Prescriber and site-of-care restrictions etc
Translate policy language into standardized, structured data fields
Flag ambiguous, conflicting, or unclear policy language
Maintain high accuracy and consistency across large document batches
Communicate edge cases and clarifications via Slack
Required Qualifications
Bachelors degree, Masters degree in Pharmacy, Pharmacy intern, or PharmD student
-
1+ years of direct experience interpreting PA requirements in:
Specialty pharmacy
Hub services
Utilization management teams within payer organizations or reimbursement and benefit verification teams.
Strong familiarity with specialty drugs and biologics
Proven ability to interpret payer policy language independently
Exceptional attention to detail
Comfort with repetitive, structured work
Preferred Qualifications
PharmD
Prior responsibility for PA interpretation or benefit determinations
Experience training or QA’ing other reviewers
How We Work
Fully remote and async-friendly, with the flexibility to work weekends or outside of standard 9–5 hours whenever it fits your schedule.
Accuracy and turnaround time tracked internally
All communication via Slack