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 & O…