About Autonomize AI
Autonomize AI is revolutionizing healthcare by streamlining knowledge workflows with AI. We reduce administrative burdens and elevate outcomes, empowering professionals to focus on what truly matters — improving lives. We're growing fast and looking for bold, driven teammates to join us.
The Opportunity
Autonomize AI is seeking a sharp, impact-oriented Clinical SME - AI Validation to lead clinical validation and drive enterprise adoption of our AI copilots across payer workflows. You’ll bridge clinical knowledge with product execution, acting as a trusted partner to both internal teams and health system leaders.
This role serves as the strategic and execution focused clinical SME for AI deployment across payer customers. It bridges clinical insight with product development and customer delivery to ensure scalable, safe, and valuable AI adoption across functions like UM, case management, and quality programs. This is not a traditional clinical reviewer role — it’s a high-ownership position for someone who thrives on ambiguity, moves with urgency, and deeply understands both the “why” and the “how” behind care management, utilization review, quality improvement, and risk adjustment. Your work will directly influence how AI gets adopted in real clinical settings.
You move fast but finish strong. You think like a builder and speak like a clinician. You don’t stop at outputs — you care about outcomes. You build trust, speak boldly, and never opt out when it matters.
Key Responsibilities
- Act as lead clinical SME for national/regional payers across core use cases.
- Design and validate AI models with QA rigor and clinical compliance for our products and solutions (e.g., validation of clinical summarization, chart review, and documentation use cases)
- Partner directly with customer clinical teams during pilots and go-lives, co-creating success criteria and ensuring embedded workflow alignment.
- Translate payer clinical workflows into repeatable AI configurations.
- Proactively bring back customer insights that improve product-market fit and influence roadmap direction.
- Serve as the clinical liaison to Product, Delivery, and Engineering on roadmap and logic design.
- Collaborate cross-functionally with Product, AI, and Customer Success to ensure every feature meets a high bar for safety, clarity, and clinical value.
- Constantly improve QA, documentation, and clinical review workflows to support velocity and scale.
- Brief execs and engineers on trade-offs, surface market intel, and recruit external SMEs when a new domain or use cases arise.
- Track and report clinical success metrics.
- Guide clinical training and adoption strategies; support frontline change management.
Required Qualifications
- RN (active or retired) with 10+ years in payer operations (UM, Case Management, Quality, HEDIS/STARS, etc.) with experience across Commercial, Medicare, Medicare Advantage, and Medicaid plans.
- Proven cross-functional leadership in clinical implementation or consulting.
- Experience with clinical QA frameworks, CMS guidelines, and health plan workflows.
- Strong communicator with ability to influence exec, clinical, and technical stakeholders.
- Deep familiarity with CMS guidelines, NCQA standards, HEDIS measures, and other regulatory frameworks relevant to health plan and provider performance.
- Strong knowledge of Medical and Payment policies in US Healthcare
- Strong ability to assess and translate clinical workflows into operational and product requirements.
- You’ve lived inside clinical workflows — and know how to break them down, improve them, and digitize them.
- Bias for action and ownership mindset — you don’t wait to be told, and you don’t stop until it’s solved.
- Proven capacity to collaborate across diverse teams and communicate clearly with both technical and clinical audiences.
- Comfort with rapid iteration and feedback — we build fast, learn faster, and refine often.
- Excellent written and verbal communication skills.
What We Offer
- A chance to make a real impact in the future of healthcare
- Autonomy, ownership, and the ability to chart your own growth path
- Competitive compensation and benefits
- 100% employer-paid health, vision, and dental insurance
- Retirement plans (401k), disability insurance, employee assistance programs
At Autonomize, we’re not just building AI for healthcare. We’re building AI with healthcare — and that starts with people like you. If you want to own hard problems, collaborate deeply, and be part of something industry-defining, we want to hear from you