Health Insurance Professional for AI Evaluation

Engage in a unique opportunity to leverage your expertise in health insurance as you collaborate with leading AI labs. This role focuses on enhancing AI systems'' reasoning in coverage determination, utilization management, and plan design. You will utilize your knowledge in commercial group and individual plans, government programs, and insurance regulations to evaluate and improve AI performance on health insurance-specific tasks.

• Review and evaluate AI-generated outputs related to plan benefit design, coverage determination, claims adjudication, and medical necessity criteria.
• Create realistic scenarios based on health insurance workflows, including prior authorization decisions, explanation of benefits reviews, formulary exceptions, network adequacy assessments, and regulatory audits.
• Annotate, label, and validate data across various health insurance use cases, such as ICD coding accuracy, payer policy interpretation, and managed care utilization review.
• Provide structured feedback on AI accuracy concerning federal and state insurance regulations, payer contracting, and industry-specific terminology.
• Collaborate asynchronously with research teams to refine evaluation frameworks for health insurance AI.

• 3+ years of professional experience at a health plan, benefits administrator, TPA, PBM, or managed care organization.
• Experience in one or more areas, including:
• Claims processing and adjudication (medical, dental, pharmacy).
• Medical underwriting or actuarial analysis for health plans.
• Utilization management or care management (UM/CM).
• Benefits administration (group, individual, Medicare Advantage, Medicaid managed care).
• Regulatory compliance, product development, or government programs (ACA, Part D, CHIP).
• Professional designations are a plus (CEBS, AHIP, HIAA, Fellow/ASA actuarial credentials).
• Strong analytical thinking and ability to translate health plan workflows into structured evaluation tasks.
• Clear written communication and attention to detail.

This is a project-based opportunity with potential for ongoing engagement based on performance and project needs.

Competitive pay based on task quality, ranging from approximately $1, 150 to $1, 450 per completed task, subject to change as the project evolves.

Top performers may receive a weekly bonus incentive in addition to their per task rate and may be invited to transition to an hourly compensation model based on sustained quality and throughput.

This role is remote and open to qualified candidates with the specified experience and qualifications.