Quantile Health · 1 week ago
Prior Authorization Specialist, Data Extraction & AI Quality (Fully Remote, Part-Time)
United States
Part-time
Remote
Entry Level
$30/hr - $60/hr
1+ years expQuantile 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. We’re seeking a part-time Prior Authorization specialist to work with our AI research teams to improve our access agent, focusing on identifying patient access gaps and improving model accuracy.
Health CareMedicalPayments
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
Qualification
Required
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
PharmD
Prior responsibility for PA interpretation or benefit determinations
Experience training or QA'ing other reviewers
Company
Quantile Health
Quantile Health payment platform offers accessible gene and cell therapies by having deals with manufacturers.
11-50 employees
Funding
Current Stage
Early StageTotal Funding
$7.71M2024-02-02Series Unknown· $7.71M
Leadership Team
Yutong Sun
Co-founder & CEO
Recent News
2025-02-12
Company data provided by crunchbase