About the Role
DoctusTech builds AI agents for value-based care organizations, covering HCC risk adjustment, coding compliance, HEDIS, and clinical documentation.
This is a hands-on role. You will personally review AI outputs against medical records, quantify accuracy, build the models that measure clinical and financial impact, and give engineering precise, evidence-backed feedback. You will be the clinical quality gate before anything ships to customers.
Key Responsibilities
Clinical QA of AI Outputs
• Review AI-generated HCC suggestions, compliance flags, and documentation outputs against source records, line by line.
• Validate each diagnosis against MEAT criteria, diagnostic status (active vs. history), and current coding guidelines.
• Build and maintain gold-standard chart sets used to test agent performance. • Score agent outputs for precision, recall, and false positive rate, and track trends across releases.
• Identify error patterns and write transparent, reproducible defect reports for engineering and data science.
• Sign off on clinical quality before releases.




Risk Adjustment Analysis
• Apply CMS-HCC V28 logic, including hierarchies, interaction terms, and RAF calculation.
• Assess RADV exposure on sampled charts: unsupported HCCs, error rates, and financial impact.
• Track CMS model and rule changes and translate them into product requirements.
Excel Modeling & Reporting
• Build Excel models from scratch for RAF impact, PMPM and PMPY revenue, coding accuracy, and customer ROI.
• Reconcile agent output data against claims, encounter, and chart review data. • Produce clear accuracy and impact reports for internal teams and customers.
Cross-Functional Work
• Turn clinical findings into specifications, acceptance criteria, and test cases for engineering.
• Support customer teams with clinical answers on audits, accuracy questions, and coding disputes.

Required Qualifications
• Medical degree (MBBS, MD, or equivalent) or another clinical degree with deep risk ad

📌 Clinical QA and Risk Adjustment Lead (India)
🏢 DoctusTech
📍 India