Data Scientist / Engineer, Healthcare Payment Integrity

📋 Description

• Actively support the US Health roadmap and serve clients by working with a variety of data types, including structured claims data, free text, documents, and images.

• Develop and implement data pipelines that are optimized for Large Language Models (LLMs) and multi-modal systems.

• Design, create, and deploy LLM-driven solutions for claims processing, document comprehension, and other relevant applications.

• Explore Agentic AI technologies and create a Minimum Viable Product (MVP) for advanced payment integrity solutions.

• Develop custom tools that enable the agent to query internal databases, access external weather APIs, or compute impact force from telemetry data.

• Set up comprehensive evaluation frameworks to guarantee that the agent's decisions are unbiased, legally sound, and easily understandable.

• Adhere to responsible AI practices, including privacy protection, hallucination minimization, explainability, and compliance.

• Facilitate client workshops, showcase prototypes, gather feedback, and assist in defining roadmap priorities.

⛳️ Requirements

• A minimum of 3 years of experience in Data Science and Healthcare Insurance Payment Integrity.

• Advanced skills in production-level object-oriented programming (OOP) for creating scalable and dependable systems.

• Proven practical experience with Large Language Models (LLMs) and generative AI methodologies, including Retrieval-Augmented Generation (RAG), embeddings, prompt engineering, and model fine-tuning.

• Strong understanding of machine learning fundamentals with applicable experience covering the entire machine learning lifecycle, including model assessment, monitoring, versioning, and deployment in production settings.

• Experience in designing and implementing robust data pipelines for document processing, Optical Character Recognition (OCR), and multi-modal data workflows.

• Familiarity with integrating frameworks such as LangChain/LangGraph, OpenAI Agent SDK, CrewAI, and A2A/MCP with Databricks or Azure-hosted models.

• Proven ability to effectively communicate with clients, translate complex business requirements into clear and actionable technical solutions, and manage stakeholder expectations.

🏝️ Benefits

• Flexible remote and hybrid working arrangements.

• Competitive salary with a variable component linked to personal and company performance.

• Numerous Learning and Development opportunities, including Focus Fridays—a half-day each month dedicated to learning and personal growth.

• Generous paid time off (PTO) and paid holidays.

• Mental health support benefits.

• 2 Make A Difference (MAD) Days per year for paid volunteering.