Medical Director, Clinical AI

Pelago is the leading specialty substance use care provider, built on the belief that effective treatment means matching care intensity to what each member actually needs rather than defaulting to the most expensive intervention. Our programs guide members through every stage of the substance use spectrum, from unhealthy habits to active use disorders, delivering personalized treatment for tobacco, alcohol, opioid, cannabis, and stimulant use based on individual health, habits, genetics, and goals.

With Sona, our voice-first AI Mental Health Specialist, Pelago now applies that same clinically-driven model to mental health, pairing deep clinical expertise with technology to expand access without compromising care quality. We believe technology should make clinical care more precise and more human, not replace the judgment behind it.

Pelago has scaled to helping hundreds of employers and health plans and has already helped more than 750,000 members better manage their substance use. If you're passionate about AI and making an impact on the health of others, join us and make it happen!

Overview of the Role

This is a senior leadership role that sits at the intersection of clinical medicine and AI product development. We're looking for a physician-leader who can serve as Pelago's clinical backbone — setting and owning clinical standards across our care programs — while serving as the embedded clinical authority for Pelago's AI-powered care platform.

You'll work closely with our VP of Care Delivery, Chief Scientific Officer, and cross-functional teams across Product, Engineering, Clinical Research, and Growth to ensure Pelago's care is safe, effective, and scalable — and that our AI products are grounded in rigorous clinical judgment. This role requires a leader who can hold the clinical line with integrity while thriving in a fast-moving, mission-driven environment and speaking the language of both medicine and machine learning.

This is a hybrid role with a high-collaboration rhythm (3 days/week in our NYC office).

In This Role You Will Own

• Clinical Leadership & Oversight
• Own clinical protocols, guidelines, and quality standards across Pelago's care model

Provide oversight and supervision to the care team as needed; serve as the primary escalation point for complex or high-acuity clinical cases

Ensure clinical practice stays current with evidence-based research, regulatory requirements, and licensing standards

Lead ongoing clinical quality review, including outcomes measurement and protocol refinement

Oversee medication-assisted treatment (MAT/MOUD) programs and ensure prescribing practices align with clinical and regulatory standards

Serve as clinical supervisor for Pelago's AI-driven care programs, ensuring AI-assisted care meets Pelago's standards for quality, compliance, and documentation

AI Product Collaboration & Clinical AI Governance

Serve as the embedded clinical voice in product development — participate in design reviews, prompt iteration, annotation, and model output evaluation alongside Product and Engineering

Oversee clinical operations of the AI arm, including annotation strategy, safety protocols, clinical routing logic, and escalation pathways

Work closely with Product, Engineering, and Design to provide structured clinical feedback and ongoing quality review that keeps AI tools grounded in evidence-based care

Define and maintain clinical governance for AI-assisted care — QA standards, escalation pathways, and documentation that meet Pelago's compliance and regulatory bar

• Help define how care team roles and responsibilities evolve as automation scales
• Build the feedback loop between AI-assisted and human-delivered care — partner with Care Managers so transitions and escalations are seamless
• Compliance
• Support clinical credentialing, licensure, and compliance workstreams across all operating states
• Partner with the Chief Scientific Officer on clinical standards, research alignment, and program validation

Team & Organizational Strategy

• Partner with the VP of Care Delivery on the clinical strategy underpinning Pelago's member experience roadmap
• Represent clinical priorities in cross-functional strategy discussions, standing in for the VP of Care Delivery when needed
• Support hiring, onboarding, and ongoing clinical development of care team members as needed

Lay the groundwork (workflows, hiring plan, SME contributor pool) to grow the Clinical AI function into a team within 12–18 months

The Background We're Looking For

MD, DO or Ph.D. with active, unrestricted license in good standing; Board-certified in Addiction Medicine, Psychiatry, or a closely related specialty

7+ years of clinical experience; prior leadership experience in a digital health, health tech, or multi-site clinical setting strongly preferred

• Deep expertise in substance use disorder treatment, including MAT/MOUD protocols
• Familiarity with co-occurring mental health conditions, CBT, and motivational interviewing

Experience working at the intersection of clinical care and AI/technology — not just as an end user, but as a clinical collaborator inside a product or engineering team

Strong AI fluency: familiar with the current state of the art, able to iterate on prompts, evaluate model outputs, and understand LLM capabilities and failure modes in a clinical context

Exceptional communicator — able to translate clinical complexity for product teams, employer clients, and executive stakeholders; comfortable being the loudest clinical voice in a product room

• Comfort navigating a fast-moving startup environment where clinical judgment and pragmatism both matter
• Experience with value-based care models, employer-sponsored health programs, or health plan contracting is a plus
• Multi-state licensure or willingness to obtain is preferred
• NYC-based or willing to relocate; hybrid presence expected

What You’ll Love About Us

We have a whole host of perks for our people! From life essentials to nice-to-haves, there are more than a few good reasons to love working with us. We strive to ensure Pelago employees have equitable access to healthcare, wellbeing, time away, and then some.

• Generous and meaningful equity package
• Full Medical, Dental, & Vision coverage
• 401k Plan
• Unlimited PTO Policy, 10 paid holidays, & company wide “Me Time” Days
• Paid maternity, paternity & new parent leave
• Flexible working environment
• Annual Learning and Development stipend to support continued learning and career development
• Wellness Reimbursement Program
• Access to Reproductive & Family Planning Care
• Substance Use Support for employees and family members
• At this time, we are unable to offer visa sponsorship for this position.

Please note that Pelago is dedicated to providing accommodations to candidates upon request. If you need accommodations at any point throughout the interview process, please reach out to your recruiter.

The provided range reflects our US target salary range for this full-time position, which is part of our broader total compensation package, including incentive bonus program, stock options, comprehensive benefits, and incentive pay applicable to eligible roles.

Individual pay within the range will vary based on a variety of factors like role-related experience and education, internal pay equity, and other relevant business factors. At Pelago, we are committed to an equitable and fair pay philosophy and review total compensation for our employees at least twice a year.

• Base Pay Range
• $275,000—$325,000 USD