AI Scientist

🤖 Clinical AI Scientist

📍 Dubai

💰 35K-40K AED per month

We are looking for a Clinical AI Scientist with deep expertise in Utilization Management (UM) to join my clients innovative Data & AI team. This pivotal role bridges clinical operations and AI technology, focusing on validating and enhancing AI-driven solutions that support prior authorization, concurrent review, inpatient/outpatient adjudication, and medical necessity assessments within our health insurance platform.

If you have strong clinical experience combined with a passion for AI innovation, this is your chance to be a subject matter expert driving the accuracy, compliance, and continuous improvement of AI models that impact patient care and payer operations.

Key Responsibilities:

• Lead clinical validation of AI solutions integrated into utilization management workflows.
• Collaborate with data scientists and engineers to test AI models using real-world claims, clinical, and authorization data.
• Review and audit AI outputs (approval/denial recommendations, level-of-care classifications) against clinical guidelines and utilization standards.
• Develop and execute robust QA and UAT protocols to ensure clinical accuracy, sensitivity, and compliance.
• Analyze model performance, identify edge cases, and recommend data augmentation or retraining as needed.
• Support curation of medical knowledge bases and guideline repositories (e.g., MCG, InterQual, CMS LCD/NCD).
• Work closely with medical policy, case management, and prior authorization teams to integrate domain expertise into AI lifecycle.
• Document model assumptions, risk assessments, and validation reports to satisfy regulatory and audit requirements.
• Contribute to creation of clinical scenarios, test datasets, and annotations for supervised learning models.
• Act as a clinical ambassador ensuring AI solutions are explainable, safe, and user-friendly.

Qualifications:

• RN, MD, NP, PA, or equivalent advanced clinical degree required.
• Minimum 5 years’ experience in Utilization Management, Prior Authorization, Case Review, or Medical Necessity Review within payer or health-tech environments.
• Basic proficiency with data science tools such as SQL, Python, and Excel.
• Experience supporting AI/ML model development or testing strongly preferred.
• Familiarity with EHRs, BRMS systems (e.g., Drools), and clinical decision support systems is a plus.

Soft Skills:

• Strong critical thinking and meticulous attention to detail.
• Excellent communication and documentation skills for effective collaboration across Data Science, Product, and Clinical teams.
• Passionate about advancing healthcare through ethical AI innovation.

Preferred:

• Prior experience in AI model validation, annotation, or testing in health insurance or digital health settings.
• Knowledge of evidence-based clinical guidelines and coding systems (ICD, CPT, DRG, HCPCS).
• Understanding of the UAE/MENA healthcare landscape and payer workflows is advantageous.