Translate business and clinical requirements into machine learning use cases focused on automation, decision support, and risk prediction in the utilization management domain
Adapt and optimize existing machine learning techniques—including classification, NLP, and time series modeling—to address specific operational workflows and data structures
Collaborate with developers to rapidly prototype and iterate on ML models with a focus on production-readiness, scalability, and integration into customer-facing products
Contribute to the design of intelligent services (e.g., automated prior authorization, clinical rule learning, denial prediction) that directly impact product capabilities
Collaborate with data engineers to acquire, preprocess, and structure healthcare data from diverse sources (claims, EHR, clinical notes)
Perform data wrangling and feature engineering to enable robust modeling pipelines
Evaluate and tune model performance using business-relevant metrics (e.g., precision, recall, F1, ROI), ensuring alignment with product goals and customer needs
Partner with product managers, designers, and software engineers to embed ML capabilities into digital products and decision support tools
Develop documentation, model APIs, and integration specifications to support seamless model deployment in production systems
Provide insights and recommendations to support product roadmap decisions and feature prioritization
Ensure ML solutions are reliable, maintainable, and explainable, implementing monitoring and retraining strategies to maintain performance and adapt to data drift
Align development with healthcare compliance requirements (HIPAA, HITRUST, SOC 2) and promote ethical use of AI
Stay up to date with emerging research in ML and health AI and conduct competitive analysis of commercial and open-source AI/ML tools
Contribute to internal knowledge sharing and build a culture of applied innovation and product-driven development
Requirements
At least 3 years of experience in applied Machine Learning (ML) or data science
1 year of experience integrating ML into software products
Experience working with real-world healthcare data, claims, Electronic Health Record (EHR), and clinical text
Experience applying ML to structured and unstructured data, particularly in classification, NLP, or time series forecasting
Strong Python programming skills
Knowledge of ML libraries: scikit-learn, TensorFlow, PyTorch, Hugging Face, or XGBoost
Knowledge of model evaluation, validation, and operational considerations (e.g., scalability, explainability, monitoring)
Master’s degree in Computer Science, or a related field
PhD in Computer Science, or a related field (listed)
Ability to sit at a desk and utilize a computer, telephone, and other basic office equipment
Must pass Background Screen and Drug Screen prior to employment
Employees required to adhere to HIPAA regulations and company policies regarding confidentiality, privacy, and security of sensitive health information
Preferred: Experience with MLOps tools and practices (e.g., MLflow, SageMaker, Airflow, Docker)
Preferred: Familiarity with clinical coding systems (ICD, CPT, SNOMED) and interoperability standards (FHIR, HL7)
Preferred: Background in building AI features in healthcare SaaS or digital health products
Preferred: Awareness of AI regulatory and ethical guidelines in healthcare (e.g., model interpretability requirements)