[Remote] Clinical Quality AI Specialist - MD/DO

Note: The job is a remote job and is open to candidates in USA. Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. We are looking for a physician to join our team as a Clinical Quality AI Specialist, responsible for clinical AI quality assurance and oversight, leading governance, validation, and monitoring of AI tools while supporting quality operations across virtual and hybrid care models.ResponsibilitiesLead pre-deployment validationProduce model cards/transparency (intended use, limits, monitoring, rollback)Partner on data quality (provenance, representativeness, refresh cadence, privacy)Build LLM evaluation datasets/gold standards; run clinical red-teams and prompt testing; refine prompts/guardrails; assess RAG fidelityTrain clinicians to oversee AI tools and adjudicate exceptions; create SOPs/checklists/escalations for LLM useCollaborate with engineering and product, security, compliance, legal, care and service line leadersAdminister clinical AI governance (ethics, safety, regulatory, privacy, change control, documentation) in partnership with the Patient Safety OfficerDefine clinical use criteria and human-in-the-loop guardrailsMaintain governance artifacts (charter, SOPs, decision logs) and audit readinessSupport clinical QA; URAC/NCQA activities; policy/standards/rubrics managementLead/participate in event detection, RCA/FMEA, CAPA; education (CME/CE, targeted training)Support client/payer audits, RFPs, VBC metrics (HEDIS, MIPS), implementations, and escalations, grievances/appealsLead and/or support cross-functional efforts to analyze clinical quality performance data, identify improvement opportunities, and translate value-based care insights into health plan design enhancements that optimize outcomes, member experience, and cost efficiencyConduct ongoing assessments of clinical services, applying continuous improvement and evidence-based methodologies to ensure service effectiveness, measurable patient outcomes, and alignment with organizational quality standardsSkillsMD/DO with active, unrestricted license3+ years clinical practice; 2+ years in quality, patient safety, or clinical operationsExperience with clinical review of LLM outputs; building eval datasets; red-teaming/prompt testing; RAG assessmentQI/patient safety expertise (PDSA, Lean/Six Sigma, RCA/RCA2, FMEA, CAPA)Working knowledge of URAC, NCQA, CMS; familiarity with HEDIS/MIPSProven track record of quality improvement within value-based care modelsExperience partnering with analytics/data science; interpret core performance metricsExcellent documentation and stakeholder communicationExperience building, deploying, and iterating, clinical AI agentsProficiency in business intelligence and analytics. (e.g., Tableau/Power BI; basic SQL/statistics)Experience in virtual care/care navigation and enterprise auditsBenefitsEquityRemote-first culture401(k) savings plan through FidelityComprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)Paid Time Off ("PTO") and Discretionary Time Off ("DTO")12 weeks of 100% Paid Parental leaveFamily Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies.Work-From-Home reimbursement to support team collaboration home office workCompany OverviewIncluded Health provides a combination of virtual care, navigation, and communities-based healthcare services. It was founded in 2011, and is headquartered in San Francisco, California, USA, with a workforce of 1001-5000 employees. Its website is http://www.includedhealth.com.Company H1B SponsorshipIncluded Health has a track record of offering H1B sponsorships, with 2 in 2026, 12 in 2025, 9 in 2024, 8 in 2023, 6 in 2022. Please note that this does not guarantee sponsorship for this specific role.