Preservice Review Nurse RN/Nurse Clinical Annotator - Remote in US
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The Registered Nurse Clinical Annotator plays a critical role in supporting the development of artificial intelligence models designed to streamline and automate prior authorization processes in healthcare. This position leverages clinical expertise to interpret, annotate, and validate medical documentation, ensuring that AI systems are trained on accurate, contextually relevant, and policy-compliant data.
General Job Profile
• Reviews the work of others
• Develops innovative approaches
• Sought out as expert
• Serves as a leader/ mentor
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
• Review medical records and interpret clinical documentation with accuracy and clinical judgment
• Apply guideline based criteria to annotate, categorize, and label case data used for AI model training
• Ensure annotations are clinically sound, consistent, and aligned with established utilization management (UM) guidelines
• Contribute to the development of high quality training datasets that support safe and effective AI model performance
• Identify gaps, ambiguities, or inconsistencies in documentation and escalate issues as needed
• Participate in refinement and continuous improvement of annotation guidelines, clinical rules, and workflows
• Collaborate with cross functional teams including data science, clinical operations, and product teams to ensure clinical accuracy and operational relevance of labeled data
• Support testing, validation, and quality review activities for AI supported UM tools and workflows
• Maintain detailed documentation of annotation decisions, rationales, and guideline interpretations
• Uphold clinical, ethical, and regulatory standards in all aspects of data handling, patient information, and annotation workflows
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
• Active, unrestricted RN license
• 3+ years of recent clinical experience in acute care, case management, utilization management, or a related clinical specialty
• Solid understanding of clinical documentation, medical terminology, and evidence based practice
• Experience applying guideline based criteria (e.g., InterQual, MCG) in clinical review or UM workflows
• Ability to interpret medical records and determine clinical appropriateness using structured criteria
• Proficiency with electronic medical records (EMR) and comfort navigating multiple clinical systems
• Familiarity with HIPAA requirements, data privacy standards, and safe handling of patient information
• Demonstrated experience performing clinical prior authorization reviews across diverse service categories, including medical/surgical procedures, diagnostic imaging, DME and related supplies, specialty therapies/devices, and other utilization management areas aligned to health plan medical policy
• Ability to work independently while maintaining productivity, quality, and adherence to annotation guidelines
• Curiosity and willingness to learn emerging technologies, AI supported workflows, and evolving guidelines
Preferred Qualifications:
• BSN
• Experience collaborating with cross functional teams (clinical, data science, operations)
• Experience with data labeling, clinical data annotation, or AI/ML workflows
• High level of accuracy, attention to detail, and commitment to consistent, high quality annotations
• Solid analytical thinking, clinical reasoning, and ability to identify gaps or inconsistencies in documentation
• Effective written communication skills, with the ability to clearly document annotation decisions and rationales
Values Based Competencies Employee
• Integrity Value: Act Ethically
• Comply with Applicable Laws, Regulations and Policies
• Demonstrate Integrity
• Compassion Value: Focus on Customers
• Identify and Exceed Customer Expectations
• Improve the Customer Experience
• Relationships Value: Act a
The Registered Nurse Clinical Annotator plays a critical role in supporting the development of artificial intelligence models designed to streamline and automate prior authorization processes in healthcare. This position leverages clinical expertise to interpret, annotate, and validate medical documentation, ensuring that AI systems are trained on accurate, contextually relevant, and policy-compliant data.
General Job Profile
• Reviews the work of others
• Develops innovative approaches
• Sought out as expert
• Serves as a leader/ mentor
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
• Review medical records and interpret clinical documentation with accuracy and clinical judgment
• Apply guideline based criteria to annotate, categorize, and label case data used for AI model training
• Ensure annotations are clinically sound, consistent, and aligned with established utilization management (UM) guidelines
• Contribute to the development of high quality training datasets that support safe and effective AI model performance
• Identify gaps, ambiguities, or inconsistencies in documentation and escalate issues as needed
• Participate in refinement and continuous improvement of annotation guidelines, clinical rules, and workflows
• Collaborate with cross functional teams including data science, clinical operations, and product teams to ensure clinical accuracy and operational relevance of labeled data
• Support testing, validation, and quality review activities for AI supported UM tools and workflows
• Maintain detailed documentation of annotation decisions, rationales, and guideline interpretations
• Uphold clinical, ethical, and regulatory standards in all aspects of data handling, patient information, and annotation workflows
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
• Active, unrestricted RN license
• 3+ years of recent clinical experience in acute care, case management, utilization management, or a related clinical specialty
• Solid understanding of clinical documentation, medical terminology, and evidence based practice
• Experience applying guideline based criteria (e.g., InterQual, MCG) in clinical review or UM workflows
• Ability to interpret medical records and determine clinical appropriateness using structured criteria
• Proficiency with electronic medical records (EMR) and comfort navigating multiple clinical systems
• Familiarity with HIPAA requirements, data privacy standards, and safe handling of patient information
• Demonstrated experience performing clinical prior authorization reviews across diverse service categories, including medical/surgical procedures, diagnostic imaging, DME and related supplies, specialty therapies/devices, and other utilization management areas aligned to health plan medical policy
• Ability to work independently while maintaining productivity, quality, and adherence to annotation guidelines
• Curiosity and willingness to learn emerging technologies, AI supported workflows, and evolving guidelines
Preferred Qualifications:
• BSN
• Experience collaborating with cross functional teams (clinical, data science, operations)
• Experience with data labeling, clinical data annotation, or AI/ML workflows
• High level of accuracy, attention to detail, and commitment to consistent, high quality annotations
• Solid analytical thinking, clinical reasoning, and ability to identify gaps or inconsistencies in documentation
• Effective written communication skills, with the ability to clearly document annotation decisions and rationales
Values Based Competencies Employee
• Integrity Value: Act Ethically
• Comply with Applicable Laws, Regulations and Policies
• Demonstrate Integrity
• Compassion Value: Focus on Customers
• Identify and Exceed Customer Expectations
• Improve the Customer Experience
• Relationships Value: Act a