Job Description Our Client is seeking a Data Scientist IV to lead the design, development, and production deployment of advanced AI and machine learning solutions within a healthcare environment. This is a highly technical, hands-on leadership role focused on building scalable solutions across Generative AI, Agentic AI, LLMs, RAG, NLP, predictive modeling, and advanced analytics.

This individual will help shape enterprise AI strategy while remaining directly involved in solution architecture and development. They will lead AI/ML solutions from prototype through production, establish technical standards and reusable frameworks, evaluate emerging AI technologies, and mentor other data scientists.

The Data Scientist IV will work closely with clinical, care management, risk adjustment, operations, IT, analytics, privacy, security, and compliance teams to ensure AI solutions deliver measurable business value while meeting healthcare data governance and

HIPAA/PHI

requirements.

Key responsibilities include:

Design and productionize scalable AI, ML, Generative AI, Agentic AI, NLP, and RAG solutions.

Lead predictive modeling and advanced analytics across healthcare claims, clinical, EHR/EMR, laboratory, and operational datasets.

Establish AI/ML architecture standards, technical reviews, best practices, and reusable frameworks.

Implement strong MLOps/LLMOps practices for testing, deployment, monitoring, observability, and model/prompt lifecycle management.

Evaluate emerging AI technologies and recommend adoption strategies based on business value, risk, scalability, and cost.

Ensure AI solutions meet HIPAA/PHI, privacy, security, responsible AI, and governance standards.

Partner with business and technical stakeholders to define KPIs, prioritize AI initiatives, and communicate results and roadmaps.

Serve as an enterprise SME and technical leader for AI, machine learning, and advanced analytics.

Location:

100%

RemoteSchedule:

Eastern Time preferred; flexibility for strong candidates

Travel:

Minimal/occasional Skills and Requirements 8+ years of experience in data science, predictive analytics, machine learning, or a related field, ideally within healthcare or managed care.3+ years of technical leadership, solution ownership, architecture, or mentoring experience.3+ years of hands-on experience delivering LLM and/or Generative AI solutions from prototype through production, including prompt engineering, RAG, and/or fine-tuning approaches.

Strong expertise across Generative AI, Agentic AI, LLMs, NLP, deep learning, predictive modeling, and machine learning.

Experience operationalizing AI/ML solutions using MLOps/LLMOps, including CI/CD, model/prompt versioning, testing, monitoring, observability, and scalable production pipelines.

Strong SQL skills and experience working with large healthcare datasets such as claims, EHR/EMR, laboratory, utilization management, and clinical/operational data.1+ year of experience with a major cloud platform such as Azure, AWS, or GCP and a modern data platform such as Databricks or Snowflake.

Strong understanding of healthcare data, managed care, HIPAA/PHI, AI governance, privacy, security, and responsible AI practices.

Bachelor's degree in Data Science, Mathematics, Statistics, Engineering, Computer Science, or related field, or equivalent relevant professional experience.

Master's degree in Data Science, Computer Science, Statistics, Mathematics, Engineering, or a related field.

Experience designing Agentic AI and RAG architectures and evaluating LLM performance, quality, latency, scalability, and cost.

Experience with AI-powered document intelligence, OCR, language extraction, annotation, retrieval, and review workflows.

Knowledge of healthcare payer/provider operations, risk adjustment, care management, and utilization management.

Knowledge of healthcare coding including CPT-4, HCPCS, ICD-9/10, DRG, and Revenue Codes.

Experience establishing enterprise AI standards, reusable frameworks, design reviews, and technical best practices. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.