Clinical & Health Specialist
- Salary
- $25–$130/hr
- Hiring from
- United States
- Work type
- Remote
- Posted
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Clinical & Health Specialist
Remote
Role Role/Domain | Exp | Geo
Utilization Management Nurse | 3y
Clinical Social Worker | 3y
Quality & Patient Safety Nurse| 8y
Medical Coder / CDI | 3y
Clinical Pharmacist | 3y
Employment Type Contractor assignment (no medical/paid leave
Engagement Length 12 weeks
Commitment Required: Full-time or Part time. 40h or 20h per week with 4 hours PST overlap.
Utilization Management Nurse | 3y
Clinical Social Worker | 3y
Quality & Patient Safety Nurse| 8y
Medical Coder / CDI | 3y
Clinical Pharmacist | 3y
Employment Type Contractor assignment (no medical/paid leave
Engagement Length 12 weeks
Commitment Required: Full-time or Part time. 40h or 20h per week with 4 hours PST overlap.
Role Overview
We are seeking experienced Clinical & Health Subject Matter Experts (SMEs) to author, evaluate, and calibrate high-fidelity clinical tasks, long-chart scenarios, workplace simulations, and benchmark evaluation rubrics. This unified opening covers contributors across multiple clinical, behavioral-health,
revenue-cycle, quality, pharmacy, rehabilitation, and healthcare-operations disciplines. Candidates will be placed in either an Expert Contributor or Senior Specialist / Functional Lead track based on clinical depth, years of experience, active licensure or certification, leadership experience, and prior review or calibration expertise.
Clinical & Health Disciplines Covered
● Acute-Care Physical, Occupational, and Speech-Language Therapy
● Pathology, Laboratory Cytotechnology, and Genetic Counseling
● Utilization Management, Prior Authorization, and Payer Claims
● Dietetics, Nutrition, Diabetes Education, and Chronic-Disease Education
● Hospital Social Work and Behavioral-Health Therapy
● Clinical Quality Improvement, Patient Safety, Infection Prevention, and EVS Policy
● Medical Coding, CDI, Billing, and Denials
● Hospital Pharmacy and Clinical Pharmacology
● Psychiatry, Addiction Medicine, and Behavioral Health
● Emergency Medicine, EMS Medical Direction, Paramedic, and EMT Handoffs
Requirements
● Approximately 3 to 15+ years of demonstrable professional experience in one or
more relevant Clinical & Health disciplines.
● Current or recent practice within the last three years in the applicable clinical, hospital, payer, laboratory, behavioral-health, revenue-cycle, or quality setting.
● Active professional licensure, board certification, or recognized credential appropriate to the discipline.
● Strong clinical reasoning, chart-review, documentation, and written communication skills.
● Ability to interpret fragmented medical records, reconcile conflicting information, identify missing or unsafe actions, and produce clinically defensible conclusions.
● High attention to detail, particularly regarding patient safety, clinical terminology, medical necessity, coding accuracy, payer requirements, regulatory standards, and documentation gaps.
● Ability to work within structured review cycles, standardized rubrics, and fast- paced calibration environments.
● Familiarity with US clinical guidelines, payer policies, regulatory requirements, and healthcare workflows is preferred. Relevant reference materials may be supplied in context for non-US contributors.
Role-Specific Qualifications
Depending on the assigned discipline, relevant qualifications may include:
● Active PT, OT, SLP, RN, RD/RDN, LCSW, PharmD, MD, DO, or other applicable professional license.
● Board certification or specialist credentials such as BCPS, BCCCP, CIC, CPHQ,
CPPS, CCS, CPC, CDIP, CCDS, CDCES, ABEM, ABPN, ABPM, or equivalent.
● Experience with acute-care rehabilitation, swallow evaluation, nutrition support, diabetes education, utilization management, prior authorization, payer appeals, medical coding, CDI, infection prevention, NHSN reporting, medication reconciliation, addiction medicine, emergency medicine, or EMS medical
direction.
● Experience authoring or reviewing complex clinical documentation, longitudinal charts, discharge plans, medical-necessity determinations, coding
assignments, safety assessments, or quality audits.
Responsibilities
1. Clinical Benchmark Authoring & Task Design: Develop high-difficulty clinical tasks, long-chart scenarios, realistic workplace cases, gold-standard answers, and evaluation criteria within the assigned discipline.
2. Longitudinal Chart Synthesis: Evaluate fragmented, multi-encounter records and identify clinically meaningful trends, contradictions, omissions, risks, and
required actions.
3. Clinical Accuracy & Safety Review: Assess whether outputs are clinically
accurate, practical, evidence-aligned, patient-safe, and appropriate for the
relevant care setting.
4. Rubric Application & Scoring: Apply evaluation criteria defined by the Functional
SME Lead to assess outputs for clinical reasoning, terminology, documentation
quality, regulatory alignment, payer accuracy, and patient-safety implications.
5. Specialty Task Evaluation: Depending on the assigned area, review tasks
involving mobility and discharge planning, swallow and diet-texture
recommendations, medical necessity, prior authorization, claims and denials,
nutrition support, diabetes management, psychosocial safety, infection
prevention, coding and CDI, medication safety, addiction treatment, emergency
decision-making, or EMS handoffs.
6. Peer Review & Calibration — Senior Track: Review and calibrate pod members’
work, resolve edge-case ambiguities, identify rubric inconsistencies, and
maintain day-to-day quality standards.
7. Cross-Functional Review: Evaluate tasks that require coordination across
physicians, nurses, therapists, pharmacists, social workers, dietitians, coders,
case managers, payers, laboratory professionals, or emergency personnel.
8. Iterative Refinement: Incorporate calibration feedback, revise task content and
solutions, and participate in multiple critique cycles to align deliverables with
project standards.
9. Escalation & Quality Ownership — Senior Track: Escalate genuine clinical,
regulatory, or rubric ambiguities to the Functional SME Lead and support
consistent decision-making across the pod.
Education & Experience
● Bachelor’s degree, graduate degree, professional degree, or equivalent practical
experience in a relevant healthcare discipline.
● Active professional license, board certification, or recognized industry credential where applicable.
● Experience in clinical practice, healthcare operations, medical review, AI evaluation, data annotation, content review, quality assurance, clinical
documentation, or a related analytical role is preferred.
● Prior experience reviewing expert work, creating clinical education content,
developing assessment materials, or participating in quality-improvement
programs is advantageous.
Senior Specialist / Functional Lead Expectations
Senior contributors may be responsible for:
● Authoring high-difficulty tasks and gold-standard solutions.
● Reviewing and calibrating work produced by Expert Contributors.
● Maintaining quality across a designated Clinical & Health pod.
● Resolving complex clinical, safety, documentation, payer, or regulatory edge cases.
● Supporting rubric development and identifying gaps in evaluation criteria.
● Grading adjacent specialties where clinically appropriate, such as behavioral- health safety, nursing documentation, case management, paramedic handoffs,
payer claims, or clinical quality tasks.
We are seeking experienced Clinical & Health Subject Matter Experts (SMEs) to author, evaluate, and calibrate high-fidelity clinical tasks, long-chart scenarios, workplace simulations, and benchmark evaluation rubrics. This unified opening covers contributors across multiple clinical, behavioral-health,
revenue-cycle, quality, pharmacy, rehabilitation, and healthcare-operations disciplines. Candidates will be placed in either an Expert Contributor or Senior Specialist / Functional Lead track based on clinical depth, years of experience, active licensure or certification, leadership experience, and prior review or calibration expertise.
Clinical & Health Disciplines Covered
● Acute-Care Physical, Occupational, and Speech-Language Therapy
● Pathology, Laboratory Cytotechnology, and Genetic Counseling
● Utilization Management, Prior Authorization, and Payer Claims
● Dietetics, Nutrition, Diabetes Education, and Chronic-Disease Education
● Hospital Social Work and Behavioral-Health Therapy
● Clinical Quality Improvement, Patient Safety, Infection Prevention, and EVS Policy
● Medical Coding, CDI, Billing, and Denials
● Hospital Pharmacy and Clinical Pharmacology
● Psychiatry, Addiction Medicine, and Behavioral Health
● Emergency Medicine, EMS Medical Direction, Paramedic, and EMT Handoffs
Requirements
● Approximately 3 to 15+ years of demonstrable professional experience in one or
more relevant Clinical & Health disciplines.
● Current or recent practice within the last three years in the applicable clinical, hospital, payer, laboratory, behavioral-health, revenue-cycle, or quality setting.
● Active professional licensure, board certification, or recognized credential appropriate to the discipline.
● Strong clinical reasoning, chart-review, documentation, and written communication skills.
● Ability to interpret fragmented medical records, reconcile conflicting information, identify missing or unsafe actions, and produce clinically defensible conclusions.
● High attention to detail, particularly regarding patient safety, clinical terminology, medical necessity, coding accuracy, payer requirements, regulatory standards, and documentation gaps.
● Ability to work within structured review cycles, standardized rubrics, and fast- paced calibration environments.
● Familiarity with US clinical guidelines, payer policies, regulatory requirements, and healthcare workflows is preferred. Relevant reference materials may be supplied in context for non-US contributors.
Role-Specific Qualifications
Depending on the assigned discipline, relevant qualifications may include:
● Active PT, OT, SLP, RN, RD/RDN, LCSW, PharmD, MD, DO, or other applicable professional license.
● Board certification or specialist credentials such as BCPS, BCCCP, CIC, CPHQ,
CPPS, CCS, CPC, CDIP, CCDS, CDCES, ABEM, ABPN, ABPM, or equivalent.
● Experience with acute-care rehabilitation, swallow evaluation, nutrition support, diabetes education, utilization management, prior authorization, payer appeals, medical coding, CDI, infection prevention, NHSN reporting, medication reconciliation, addiction medicine, emergency medicine, or EMS medical
direction.
● Experience authoring or reviewing complex clinical documentation, longitudinal charts, discharge plans, medical-necessity determinations, coding
assignments, safety assessments, or quality audits.
Responsibilities
1. Clinical Benchmark Authoring & Task Design: Develop high-difficulty clinical tasks, long-chart scenarios, realistic workplace cases, gold-standard answers, and evaluation criteria within the assigned discipline.
2. Longitudinal Chart Synthesis: Evaluate fragmented, multi-encounter records and identify clinically meaningful trends, contradictions, omissions, risks, and
required actions.
3. Clinical Accuracy & Safety Review: Assess whether outputs are clinically
accurate, practical, evidence-aligned, patient-safe, and appropriate for the
relevant care setting.
4. Rubric Application & Scoring: Apply evaluation criteria defined by the Functional
SME Lead to assess outputs for clinical reasoning, terminology, documentation
quality, regulatory alignment, payer accuracy, and patient-safety implications.
5. Specialty Task Evaluation: Depending on the assigned area, review tasks
involving mobility and discharge planning, swallow and diet-texture
recommendations, medical necessity, prior authorization, claims and denials,
nutrition support, diabetes management, psychosocial safety, infection
prevention, coding and CDI, medication safety, addiction treatment, emergency
decision-making, or EMS handoffs.
6. Peer Review & Calibration — Senior Track: Review and calibrate pod members’
work, resolve edge-case ambiguities, identify rubric inconsistencies, and
maintain day-to-day quality standards.
7. Cross-Functional Review: Evaluate tasks that require coordination across
physicians, nurses, therapists, pharmacists, social workers, dietitians, coders,
case managers, payers, laboratory professionals, or emergency personnel.
8. Iterative Refinement: Incorporate calibration feedback, revise task content and
solutions, and participate in multiple critique cycles to align deliverables with
project standards.
9. Escalation & Quality Ownership — Senior Track: Escalate genuine clinical,
regulatory, or rubric ambiguities to the Functional SME Lead and support
consistent decision-making across the pod.
Education & Experience
● Bachelor’s degree, graduate degree, professional degree, or equivalent practical
experience in a relevant healthcare discipline.
● Active professional license, board certification, or recognized industry credential where applicable.
● Experience in clinical practice, healthcare operations, medical review, AI evaluation, data annotation, content review, quality assurance, clinical
documentation, or a related analytical role is preferred.
● Prior experience reviewing expert work, creating clinical education content,
developing assessment materials, or participating in quality-improvement
programs is advantageous.
Senior Specialist / Functional Lead Expectations
Senior contributors may be responsible for:
● Authoring high-difficulty tasks and gold-standard solutions.
● Reviewing and calibrating work produced by Expert Contributors.
● Maintaining quality across a designated Clinical & Health pod.
● Resolving complex clinical, safety, documentation, payer, or regulatory edge cases.
● Supporting rubric development and identifying gaps in evaluation criteria.
● Grading adjacent specialties where clinically appropriate, such as behavioral- health safety, nursing documentation, case management, paramedic handoffs,
payer claims, or clinical quality tasks.
This is a remote position.
Compensation: $25.00 - $130.00 per hour
DONATO TECHNOLOGIES WAS FOUNDED IN 2012, WE SPECIALIZE IN STAFFING, CONSULTING, SOFTWARE DEVELOPMENT, AND TRAINING ALONG WITH IT SERVICES.
INFORMATION TECHNOLOGY REMAINS OUR STRENGTH!
We partner with clients, appreciate, and understand their business needs and bring them the most innovative and relevant technology solutions available.
Our experience has made us who we are today. We have partnered with a lot of clients and built technology that powers their business.
Careers
At Donato Technologies, Inc., we unite top-tier talent within a creative, collaborative, and supportive atmosphere, transforming daunting challenges into enjoyable and rewarding pursuits.
As a valued member of our team, you’ll experience unparalleled opportunities to engage with both clients and cutting-edge technology.
As a valued member of our team, you’ll experience unparalleled opportunities to engage with both clients and cutting-edge technology.
We serve as the ultimate destination for talented individuals with aspirations and ambitions, addressing companies’ growth needs comprehensively. We hold our clients, consultants, and talent in the highest regard.
If you’re prepared to embark on a career in the technology fast lane, Donato is your ideal destination.
