Data Scientist / Engineer (Healthcare Payment Integrity)

About the Team

• This role is part of our Data Science team which is the largest team in our organization consisting of over 200+ Data Scientists throughout the world.
• Our Data Scientists work in a full lifecycle role and on a broad range of subjects acquiring extensive technical and professional experience in data science, data engineering, coding, business understanding and client engagement.
• Our company is small enough that each person’s achievements have an impact on our overall performance, yet big enough to be a world leader and innovator in our domain.
• As a member of the data science team, you will be working alongside our technical experts and your role will be key to rolling out our enterprise level solutions to our clients.

Key Responsibilities

• Your role will be to actively contribute to the US Health roadmap and clients, and working on various data types such as structured claims data, free text, documents and images.
• Build and productionize data pipelines (structured, text, documents, images) optimized for LLMs and multi-modal models.
• Design, develop and deploy LLM-based solutions (RAG, embeddings, instruction tuning) for claims handling, document understanding, and related use cases.
• Experiment with the latest in Agentic AI technologies (Langchain/Langgraph, OpenAI Agent SDK, MCP, A2A) and develop MVP for the next generation of payment integrity solutions.
• Create custom "tools" for the agent, allowing it to query internal databases, call external weather APIs, or calculate impact force based on telemetry data.
• Establish rigorous evaluation frameworks (LLM-as-a-judge) to ensure the agent’s decisions are unbiased, legally sound, and explainable.
• Ensure responsible-AI practices: privacy, hallucination mitigation, explainability and compliance.
• Lead client workshops, present prototypes, gather feedback and help define roadmap priorities.

What We Are Looking For

We are looking for candidates with 3+ years of Data Science and Healthcare Insurance Payment Integrity experience with diverse skills to help us build excellent technology solutions for our clients and be proficient in the following skills:

• Expert proficiency in production-level object-oriented programming (OOP) for building scalable and reliable systems.
• Proven hands-on experience with Large Language Models (LLMs) and generative AI techniques (including RAG, embeddings, prompt engineering,).