Clinical & Health Care Operations Evaluation Consultant

This is a fully remote position, open to applicants in New York.

📋 Description

• Review completed AI-generated products related to clinical, healthcare operations, and medical administration.

• Analyze task instructions, supporting documents, deliverables, and evaluation outcomes.

• Evaluate whether outputs accurately represent authentic practices and workflows within the US healthcare system.

• Identify significant issues related to clinical, operational, regulatory, administrative, privacy, documentation, billing, and compliance.

• Assess the realism of tasks, terminology, constraints, expected deliverables, and relevant clinical, payer, and regulatory standards.

• Review clinical documentation and professional reasoning pertinent to the reviewer’s expertise.

• Evaluate workflows concerning healthcare practices, clinics, departments, scheduling, patient access, billing, staffing, budgets, and administration.

• Ensure compliance with HIPAA, CMS, payer, and other relevant US healthcare regulations.

• Review existing yes/no grading decisions and determine their evidential support.

• Assess the overall quality of work products and assign an appropriate quality band.

• Compare professional judgment with reported evaluation scores to identify any inaccuracies in scoring.

• Provide clear written rationales for clinical, regulatory, operational, and administrative judgments.

• Maintain consistency and meticulous attention to detail throughout reviews.

• Complete around one hour of review work for each item.

⛳️ Requirements

• Must be an experienced US healthcare professional in nursing, clinical operations, practice management, patient access, health information management, scheduling, billing, or medical administration.

• Registered Nursing: Active US RN license; over 5 years of post-licensure bedside care experience; strong practical understanding of clinical workflows and documentation; experience as a charge nurse or preceptor is particularly valuable.

• Nurse Practitioner: Board-certified Nurse Practitioner; at least 3 years managing a personal patient panel; responsible for patient assessment, treatment, and clinical documentation; solid understanding of outpatient or clinical practice.

• Medical & Health Services Management: Minimum of 5 years as a practice manager, clinic administrator, department director, or similar healthcare leader; hands-on experience with clinical budgets; experience managing healthcare operations, staffing, workflows, or service delivery; understanding of both clinical and administrative performance.

• Patient Access, HIM, Scheduling & Billing Supervision: 4 years of supervisory experience in a clinical setting; relevant experience in patient access, health information management, scheduling, or billing; hands-on responsibility for staff performance and operational workflows; strong grasp of healthcare administrative procedures.

• Medical Administration: At least 4 years as a medical secretary, medical administrative assistant, or similar role; hands-on experience in scheduling, clinical correspondence, and medical records; experience in a medical practice or hospital department; solid knowledge of healthcare administrative workflows.

• Strong practical delivery experience within the US healthcare system.

• Near-native proficiency in business English.

• Ability to provide concise written explanations for professional judgments.

• Comfortable reviewing spreadsheets, PDFs, and healthcare-related professional documents.

• Capable of verifying figures and internal consistency when applicable.

• Valuable experience includes auditing charts, training or precepting colleagues, participating in surveys, or reviewing the work of others.

• Experience primarily advising healthcare organizations without direct ownership of the underlying work is less aligned.

• Experience solely outside the US healthcare system may not offer sufficient exposure to HIPAA, CMS, payer, and other US-specific requirements.

• Must independently complete the first assignment without assistance.

• Must operate without utilizing confidential or proprietary information from any employer, client, institution, or third party.

• H1-B and STEM OPT support is not available.

🏝️ Benefits

• Engagement as a part-time independent contractor.

• Fully remote work within the United States.

• Flexible scheduling based on project requirements.

• Projects may be extended, shortened, or concluded according to project needs and performance.

• Approximately one hour of review work required per item.

• Initial recorded interview lasting approximately 15 minutes as the first step.

• H1-B and STEM OPT support is not available for this position.