The regulator that decides whether drugs are safe now runs AI across its review workflow, and its own reviewers say the tool returns inaccuracies.
Key takeaways
- The FDA deployed Elsa, a large language model tool that summarises adverse event reports, compares product labels and generates code for nonclinical databases, agency-wide to over 18,000.
- 69 live listings in this category publish a rate, at a median top-of-range of $120 an hour and a ceiling of $400.
- The work is remote contract work, asynchronous, with no set hours and no guaranteed volume.
- Applications screen on a short skills assessment rather than a resume or interview.
What was reported
The finding
The FDA deployed Elsa, a large language model tool that summarises adverse event reports, compares product labels and generates code for nonclinical databases, agency-wide to over 18,000 employees. Testimony from the Secretary of Health and Human Services stated more than 90% of FDA reviewers now use AI to accelerate drug approvals, while the FDA separately reported around 70% of staff voluntarily use Elsa. Some reviewers have noted responses containing inaccuracies or incomplete data, and two anonymous FDA staffers said Elsa could not yet assist with review work. Commentators have questioned whether it is intended for administrative efficiency or substantive scientific review.
Both halves are documented. HHS testimony put more than 90% of FDA reviewers using AI, while the FDA itself reported around 70% voluntarily using Elsa. At the same time reviewers have flagged responses containing inaccuracies or incomplete data, and two anonymous staffers said it could not yet assist with review work. In a setting where evidence standards are the entire point, small inconsistencies do not save time, they cost it.
What the listings pay
That is the case for human clinical and regulatory evaluation stated more clearly than any job listing could manage. Across 69 live clinical and regulatory listings on our board that publish a rate, the median top-of-range is $120 an hour, reaching $400.
| # | Role | Advertised rate | Platform |
|---|---|---|---|
| 1 | Healthcare Attorney (BigLaw Firms) | $140 to $400 an hour | micro1 |
| 2 | Physician Talent Network | $110 to $250 an hour | Mercor |
| 3 | Disease-Area Clinician, Trial Endpoints & Prescribing | $150 to $230 an hour | Mercor |
| 4 | Pharma Commercial Forecasting Expert, Launch Curves | $130 to $210 an hour | Mercor |
| 5 | Therapeutic Area & Clinical Survey Expert | $200 to $200 an hour | Mercor |
| 6 | Clinician (Oncology / Hematology) | $160 to $200 an hour | micro1 |
| 7 | Military/Veteran Mental Health Experts | $100 to $200 an hour | micro1 |
| 8 | Multilingual Primary Care Physician (MD): Clinical Documentation & AI Evaluation | $170 to $190 an hour | Mercor |
| 9 | Medical Safety Expert | $140 to $190 an hour | Mercor |
| 10 | Clinical Law Professor / Clinic Director | $180 to $180 an hour | Mercor |
Source: 69 live listings on this board that publish a rate, read directly from each posting on 2026-09-06. Listings without a published rate are excluded rather than estimated.
How this compares across the board
A rate only means something next to the alternatives. This is every category we track with at least five listings publishing a rate, ranked by median top-of-range, so you can see where this work sits rather than taking a single number on trust.
| Category | Listings | Median low | Median top | Highest |
|---|---|---|---|---|
| Legal | 95 | $100 | $140 | $400 |
| Medical | 68 | $77 | $120 | $400 |
| Consulting | 45 | $80 | $120 | $280 |
| Finance | 94 | $80 | $110 | $280 |
| Engineering | 114 | $70 | $100 | $300 |
| Research/PhD | 132 | $70 | $90 | $280 |
| Writing | 36 | $40 | $80 | $280 |
| Bilingual | 78 | $44 | $52 | $120 |
| Annotation | 25 | $12 | $24 | $120 |
Same source and date as above. Categories are matched on listing title, so a role can appear in more than one.
What it means for you
The work involves no patient contact and no protected health information. You are checking whether a model's clinical or regulatory reasoning holds, which is the same judgment the FDA's own reviewers are applying to Elsa. See clinical and biomedical evaluator roles.
Who should apply
Two checks before you spend time on an application. Confirm the role accepts applicants from your country with the eligibility checker, since a meaningful share of listings carry location requirements. Then run the advertised rate through the take-home calculator, because this is contract work and the headline figure is before self-employment tax.
Applications complete on the hiring platform and usually take a few minutes, with a short skills assessment in place of an interview. Fill in every credential, language and professional background field on your profile. Those are what route you to the better paid listings, and most applicants leave them blank.
Frequently asked questions
Is the FDA really using AI in drug review?
Yes. Elsa was deployed agency-wide to over 18,000 employees. HHS testimony put more than 90% of reviewers using AI; the FDA reported around 70% voluntarily using Elsa.
What does Elsa actually do?
It summarises adverse event reports, compares product labels, and generates code for nonclinical databases.
Have there been problems?
Reviewers have reported responses containing inaccuracies or incomplete data, and two anonymous staffers said it could not yet assist with review work.
What does clinical AI evaluation pay?
Across 69 live clinical and regulatory listings publishing a rate, the median top-of-range is $120 an hour, reaching $400.
Is PHI involved in this work?
No. You review model output using your clinical or regulatory knowledge, with no patient contact and no protected health information.
Sources
See every live role
The full board updates several times a week, with the advertised rate on each listing and closed roles removed.