Clinical AI Scientist – Utilization Management Focus

Job Title: Clinical AI Scientist – Utilization Management Focus

Location: Dubai / Abu Dhabi, UAE (Hybrid)

Role Summary:

My client is seeking a Clinical AI Scientist with deep expertise in Utilization Management (UM) to join their Data & AI team.

This role sits at the intersection of clinical operations and AI innovation. Focused on validating and continuously improving AI driven solutions for prior authorization, concurrent review, inpatient/outpatient

adjudication, and medical necessity assessments.

The ideal candidate combines clinical acumen with a working knowledge of AI/ML systems to serve as a subject matter expert in testing, auditing, and optimizing AI models integrated into our health insurance platform.

Key Responsibilities:

• Act as the clinical lead for validating AI solutions deployed in utilization management workflows.

• Collaborate with data scientists and engineers to test AI model performance using real-world claims, authorization, and clinical data.

• Review and audit model outputs

Qualifications:

Clinical Experience:

• RN, MD, or advanced clinical degree (e.g., NP, PA) required.

• Minimum 5 years of experience in Utilization Management, Prior Authorization,

Case Review, or Medical Necessity Review in a payer or health-tech setting.

AI/Data Familiarity:

• Basic proficiency with data science tools (e.g., SQL, Python, Excel).

• Experience working with or supporting development/testing of AI/ML models is

strongly preferred.