US Health Insurance / Utilization Management Expert

Work Mode: Remote

Engagement: Part time / Contract

Commitment: 4–5 hours/day

Openings: 3

Pay Rate: ₹2,000–₹3,000/hour

Start Date: Immediate

Role Overview

We are looking for experienced US Health Insurance / Utilization Management professionals to support an enterprise healthcare AI project. The role involves testing and reviewing AI-generated healthcare outputs, identifying errors, performing domain-level validation, and helping refine AI skills across multiple development iterations.

Required Expertise

US healthcare / payer operations experience (Mandatory)

Benefits & eligibility, deductibles, copays and coinsurance

Prior authorization & utilization management

Medical necessity and appeals preparation

Formulary and commercial payer policies

CMS NCD/LCD familiarity

Healthcare claims/payer workflows

Ability to review outputs for clinical,



payer, regulatory, and accuracy requirements

Key Responsibilities

Review and validate AI-generated healthcare responses.

Identify payer, policy, and domain-specific errors.

Perform error analysis and provide expert feedback.

Support creation and validation of healthcare golden datasets.

Validate AI outputs against real-world US healthcare practices and source evidence.

Candidate Verification

Shortlisted candidates will be required to provide:

Resume/CV, LinkedIn Profile, Experience/Employment Verification, and Degree/Qualification Certificate.

Important: Relevant US healthcare experience is mandatory. Final compensation will depend on relevant professional experience and expertise.

📌 US Health Insurance / Utilization Management Expert (India)
🏢 IOWeb3 Technologies
📍 India