How you move is why were here.
Now more than ever.

Get back to what you need and love to do.
The possibilities are endless...

Now more than ever our guiding principles are helping us in our search for exceptional talent - candidates who align with our unique workplace culture and who want to maximizethe abundant opportunities for growth and success.

If this describes you then lets talk!

HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field you will find HSS an innovative supportive and inclusive environment.

Working with colleagues who love what they do and are deeply committed to our Mission you too can be part of our transformation across the enterprise.

Emp Status

Work Shift

Compensation Range

What you will be doing

Core Competencies & Responsibilities

AI System Oversight & Compliance Auditing

Conduct routineQA and compliance auditson AI-assisted and AI-autonomous outputs across Revenue Cycle workflows (e.g. eligibility/coverage determinations authorization routing claim edits denials workflows payment/financialassistanceinteractions and other AI-mediated decisions).

Verify outputs againstpayer rules federal/state requirements and internal policies ensuring decisions aredocumented and defensible.

Ensure workflows meet governance principles ofauditability traceability and reversibilityas autonomy increases.

Depending on departmental assignment perform deep-dive validation in specific domains (e.g. verifying that system-generated CPT/diagnosis codes accurately match clinical documentation or auditing automated clinical packet generation for prior authorizations).

Exception Management & Escalation

Serve as the escalation point forlow-confidence outlier or high-risk cases flagged by AI ensuring correct resolution andappropriate handoffsto human teams.

Maintain an exceptions log categorize failure modes (policy gap vs. data issue vs. workflow design vs. model behavior) and drive corrective actions with owners

Vendor & Partner Quality Oversight:Conduct quality reviews on external vendor and technology partner performance against established operational standards and Service Level Agreements (SLAs).

Compile performance data toidentifynegative trends outputting findings into operational dashboards and vendor scorecards.

Partner with leadership to address vendor deficiencies through structured feedback and recommend corrective action plans.

Risk Monitoring & Early-Warning Controls

Monitor operational and financial signals to detect drift and emerging compliance riskexplicitly including denial trends reimbursement impact and case mix swings (and analogous indicators for non-coding AI such as auth turnaround inappropriate routing or patient balance errors).

Escalate patterns that suggest systematic error over/under-treatment of policy logic or patient financial harm risk.

Workflow Analysis & Process Improvement:Analyze operational workflows end-to-end toidentifybottlenecks redundancies and upstream clinical failure points that drive rework or compliance risk.

Establish andmaintainstandardized procedures to reduce variability as the department shifts from manual processing to AI-augmented workflows.

Maintain and continuously improve the departments knowledge base ensuring all operational policies escalation pathways and decision trees are documented to support automated workflows.

Training Communication and Operational Enablement:Provide targeted at-elbow coaching and operational support to frontline staff adjusting to new automation tools and changing workflows.

Assistin developing and delivering brief training interventions or job aids based on validated performance data andidentifiedknowledge gaps.

Educate frontline teams and stakeholders on recurring error patterns documentation/inputs that drive AI failures and how to route/resolve exceptions.

Coach and mentor staff through operational and technological change with empathy and accountability.

Governance Controls and Audit Readiness

Support and/or participate in enterprise AI governance processes including risk classification documentation standards and ongoing audit cadence aligned to risk tiering.

Ensure evidence is auditor-ready: decision rationale data lineage references versioning of policy logic and clear records of what changed when and why.

Non-Discrimination Policy
Hospital for Special Surgery is committed to providing high quality care and skilled compassionate reliable service to our community in a safe and healing environment. Consistent with this commitment Hospital for Special Surgery provides care admits and treats patients and provides all services without regard to age race color creed ethnicity religion national origin culture language physical or mental disability socioeconomic status veteran or military status marital status sex sexual orientation gender identity or expression or any other basis prohibited by federal state or local law or by accreditation standards.