Medical Director - Utilization Management and AI

Olive’s AI workforce is built to fix our broken healthcare system by addressing healthcare’s most burdensome issues -- delivering hospitals and health systems increased revenue, reduced costs, and increased capacity. People feel lost in the system today and healthcare employees are essentially working in the dark due to outdated technology that creates a lack of shared knowledge and siloed data. Olive is designed to drive connections, shining a new light on the broken healthcare processes that stand between providers and patient care. She uses AI to reveal life-changing insights that make healthcare more efficient, affordable and effective. Olive’s vision is to unleash a trillion dollars of hidden potential within healthcare by connecting its disconnected systems. Olive is improving healthcare operations today, so everyone can benefit from a healthier industry tomorrow.

Job Overview

At Olive, we’re connecting providers and payers to create the Internet of Healthcare. Our team builds and implements a suite of SaaS products that integrate across EHRs and payer systems, with intuitive workflows and deep healthcare expertise. Our transformative Utilization Management technology accelerates prior authorizations for providers and payers, and enables the first-in-the-world real-time AI clinical reviews to automate prior authorization transactions.

We are looking for a physician who is passionate about improving healthcare systems and interested in playing a leading role in helping to structure and design our AI powered product, as well as working collaboratively with our extensive community of providers and payers to transform healthcare and the patient experience. This role will report directly to EVP of Payer Product and Chief Medical Officer.

Essential Duties And Responsibilities

• Serve as the medical director defining strategy and providing clinical oversight and management of our AI powered logic against payer-specific medical necessity criteria
• Work closely with our product and engineering teams to provide clinical insight into the development, implementation and deployment of our prior authorization platform
• Directly supervise our diverse prior authorization team of UM specialists, subject matter experts, researchers and data scientists.
• Apply your knowledge and up-to-date research on evidence-based medicine to AI training, and provide key guidance for the product and your team
• Assist in the reviews and supervision of medical policies and medical necessity guidelines.
• Ensure that Olive’s AI products meet the highest standards for excellence, ethics, and regulatory compliance.
• Meet with payer prospects and customers to positively represent our product and methodology.
• Performance analysis and provides strategic input to the product leadership executive team.
• Participate in the retrospective review and analysis of product performance to provide insights and learnings.

Requirements

• MD or DO with 3-10 years clinical experience
• Active medical license and/or certification strongly preferred
• Medical Director experience, or other experience managing teams required
• Clinical informatics diplomate, AI or data science experience strongly preferred
• Excellent logical and systematic thinking, capable of apply sound reasoning to complex problems
• Prior authorization or UM management experience preferred but not required
• Previous experience working at a payer preferred, but not required

At Olive, we're committed to growing and empowering an inclusive community within our company and industry. This is why we hire and cultivate diverse teams of the best and brightest from all backgrounds, experiences, and perspectives across our organization. Research shows that oftentimes women and other minority groups only apply to open roles if they meet 100% of the listed criteria. Olive encourages everyone — including women, people of color, individuals with disabilities and those in the LGBTQIA+ community — to apply for our available positions, even if they don't necessarily check every box on the job description.

Disclaimer

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned.

This job description does not constitute a contract of employment and Olive AI, Inc. may exercise its employment-at-will rights at any time.

Benefits

We take the health and happiness of our employees seriously and consistently evaluate new ways to provide an amazing place to work. From retirement planning, to a wellness program designed to actively incorporate mental and physical wellness into daily interactions amongst fellow Olivians, we make sure to take care of our own.

• Health, Dental, and Vision insurance that starts on your first day at Olive with 100% of premiums covered for team members and 75% covered for dependents
• Monthly Grid stipend to cover work related expenses
• Unlimited PTO
• Telemedicine
• EAP/Mental health resources
• Getaways by Marriott Bonvoy
• Family-building and fertility support via Kindbody
• 12 weeks of paid parental leave
• 401(K) match
• Wellness program
• Stock Options