Director, Model Engineering – Operations

Job not on LinkedIn

🕒 5 days ago

🇺🇸 United States – Remote

💵 $135.6k - $237.4k / year

⏰ Full Time

🔴 Lead

🖥 Software Engineer

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Lead the strategy, development, implementation, and optimization of enterprise AI and machine learning solutions supporting health plan operations and business objectives • Lead design, development, and productionization of ML and AI models across risk adjustment, quality measures, care management, utilization management, fraud/waste/abuse, and member/provider experience use cases • Own the end-to-end MLOps lifecycle on Databricks, including feature engineering, feature stores, model training and versioning, CI/CD, deployment, and automated retraining • Establish model monitoring practices for drift, performance degradation, bias/fairness, and champion-challenger frameworks • Guide responsible adoption of generative AI and LLM capabilities for analytics, member/provider tools, and operational automation • Define engineering standards, design patterns, and reusable ML components • Partner with governance and security teams to ensure HIPAA, CMS, and NCQA compliance • Manage model risk documentation and validation for regulatory review, audits, and quality submissions • Own cost, performance, and reliability of the Databricks ML platform • Collaborate with BI, data engineering, and data science teams on canonical data models and lakehouse architecture • Translate clinical, quality, finance, and operations problems into scoped ML engineering initiatives with success metrics and timelines • Communicate technical strategy, risk, and progress to senior leadership and non-technical stakeholders • Lead and oversee a team of machine learning engineers and applied scientists • Perform other job-related duties as requested

🎯 Requirements

• Bachelor's degree in Computer Science, Data Science, Engineering, or related field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Eight (8) years of software/ML engineering experience required • Five (5) years of leadership experience required • Experience productionizing ML models at scale, including CI/CD, model versioning, monitoring, and retraining pipelines • Experience in regulated, PHI-governed environments • Working knowledge of HIPAA and healthcare data standards • Familiarity with health plan, payer, or healthcare provider environments • Exposure to HEDIS/Stars, HCC risk adjustment, claims (837/835), and HL7, FHIR, and CCDA standards • Knowledge of cloud infrastructure, preferably Azure, and Infrastructure-as-Code practices • Hands-on proficiency with Databricks or comparable lakehouse platforms, Delta Lake, MLflow, and Spark • Strong Python and SQL skills • Understanding of supervised and unsupervised learning, model evaluation, and feature engineering • Knowledge of modern AI/LLM concepts including RAG, embeddings, prompt engineering, and generative model evaluation • Ability to evaluate or implement knowledge graph, entity resolution, or Member 360 initiatives • Ability to present model risk or AI governance documentation to regulators, auditors, or compliance committees • Strong communication, service orientation, consulting, leadership, and management skills • Ability to work collaboratively with all levels of management • Ability to manage multiple complex priorities in a changing environment • Knowledge of outsourcing and staff augmentation strategies supporting testing processes • Knowledge of the managed care industry preferred • Licensure and certification: None • Ability to travel as required by business needs

🏖️ Benefits

• Base salary of $135,600.00–$237,400.00 • Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Total well-being support