Clinical Informatics Specialist

This is a fully remote opportunity. 

Gradient AI:     

Gradient AI is a leading provider of AI solutions for the Group Health and P&C insurance industries. Our solutions improve loss ratios and profitability by predicting underwriting and claim risks with greater accuracy, as well as reducing quote turnaround times and claim expenses through intelligent automation. Gradient AI’s SaaS platform leverages a vast industry data lake comprising tens of millions of policies and claims, providing insurers with high resolution, data-driven insights. Customers include some of the most recognized insurance carriers, MGAs, MGUs, TPAs, risk pools, PEOs, and large self-insured employers across all major lines of insurance. Founded in 2018, Gradient has experienced strong growth every year and recently raised $56 million in Series C funding from top Insurtech investors.

About the Role:

We are seeking a Clinical Informatics Specialist to collaborate with product teams in developing a health roadmap and identifying key differentiation opportunities. This role will involve providing clinical support to the data science team, assisting with model building and interpretation, and staying informed on emerging healthcare technologies, drugs, and regulatory changes that may impact our models and reporting. The ideal candidate will have a strong background in healthcare informatics, data analysis, and clinical expertise, and be able to effectively contribute to the design and implementation of key healthcare data models.

Key Responsibilities:

• Provide clinical and informatics expertise to guide product definition and development.

• Collaborate with client executives, product managers, engineers, and data scientists to design and implement:

  • Ontology structures (LOINC, RxNorm, NDC, ICD-10).

  • Logic for defining healthcare concepts like emergency room visits, length of stay, and responsible provider.

  • Episode Groupers to define disease stages and likely treatment pathways.

  • Standards for term normalization and unstructured data extraction.

• Normalize healthcare data, particularly from lab and EHR/EMR systems.

• Develop pricing logic for new drugs, devices, and maintain updated pricing data.

• Establish best practices for reference data sources and vendor selection.

• Lead efforts to streamline documentation, improve data quality, and enhance reporting.

• Maintain and update clinical content/models. 

 Qualifications:

• PharmD or MD degree is a must.

• Expertise in clinical informatics or healthcare IT.

• Hands-on experience working with EMR or claims data.

• Strong knowledge of coding standards and best practices.

• Experience in healthcare data modeling, normalization, and quality reporting.

• Comprehensive understanding of Rx, Dx, LOINC coding, and MediSpan references.

• Experience working with insurers, particularly in underwriting or as a consultant.

• Strong analytical, problem-solving, and attention-to-detail skills.

• Proven ability to work effectively in cross-functional teams, especially in fast-paced or startup environments. 

What We Offer:

• A fun, team-oriented startup culture.

• Generous stock options - we all get to own a piece of what we’re building.

• Unlimited vacation days.

• Flexible schedule that supports working from home. 

• Full benefits package includes medical, dental, vision, 401k, paid paternal leave, and more.

• Ample opportunities to learn and take on new responsibilities.   

We are an equal opportunity employer.