Head of Applied AI Research

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September 5

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Medecision

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Healthcare Insurance • Digital Health • Analytics

Medecision is a cloud-based company that provides a comprehensive data-powered platform designed for health plans, health systems, third-party administrators, and government solutions. Their platform enables organizations to improve health outcomes, reduce medical and administrative costs, and manage care effectively through digital care management, utilization management, and population health management. Medecision leverages advanced analytics and automation to optimize workflows and enhance patient engagement, supporting organizations in delivering personalized care while maximizing operational efficiency.

201 - 500 employees

Founded 1988

⚕️ Healthcare Insurance

💰 Series C on 2003-03

📋 Description

• Define and lead Medecision’s enterprise AI strategy in alignment with the company vision. • Build and manage the AI CoE as a high-performing, multidisciplinary team (data science, ML engineering, AI ethics, clinical informatics). • Act as the external face of “Medecision AI” at conferences, publications, and partnerships. • Drive applied research in agentic AI, LLMs, and predictive modeling for payer/provider use cases. • Create a structured process for piloting, scaling, and productizing AI innovations across UM, CM, Quality, and Risk products. • Partner with academic, vendor, and open-source AI communities to stay ahead of the curve. • Establish governance, compliance, and bias-mitigation frameworks for AI in healthcare. • Build reusable AI/ML infrastructure (vector DBs, orchestration, monitoring, MLOps). • Ensure AI models are explainable, auditable, and aligned with payer/provider regulatory requirements. • Partner with Product GMs and Engineering leaders to embed AI pods into each line of business. • Work closely with Clinical and Compliance teams to validate AI models against industry guidelines (e.g., InterQual, MCG, CMS). • Evangelize AI internally, building a culture of adoption and responsible innovation.

🎯 Requirements

• 12+ years of experience in AI/ML, data science, or advanced analytics, with at least 5 in leadership roles. • Proven track record building and scaling AI capabilities within healthcare, life sciences, or regulated industries. • Deep expertise in applied AI/ML, including large language models (LLMs), RAG, NLP, predictive analytics, and MLOps. • Strong knowledge of healthcare workflows (UM, CM, claims, risk adjustment, quality measures). • Demonstrated ability to recruit, inspire, and lead world-class AI talent. • Excellent communication skills; ability to translate complex AI concepts into business outcomes. • Passion for improving healthcare outcomes and reducing costs through innovation.

🏖️ Benefits

• Impact at Scale: Shape how millions of members experience care through intelligent automation. • Innovation Culture: Lead a greenfield AI initiative inside an established healthcare SaaS leader. • Talent Magnet: Build the most visible AI team in the payer space. • Mission Driven: Apply your skills to bend the cost curve, improve access, and enhance quality of care.