Design, develop, and productionize machine learning solutions including document understanding, search, and generative AI applications. Collaborate with cross-functional teams to integrate AI models into backend services while ensuring data security and HIPAA compliance.
Judi Health
10 Remote Job Openings at Judi Health
Design, develop, and productionize machine learning solutions including GenAI, NLP, and search applications. Collaborate with cross-functional teams to integrate AI models into backend services while ensuring system robustness and HIPAA compliance.
The role involves preparing prior authorization requests by validating member information and obtaining necessary clinical data from providers. It also requires triaging calls and analyzing pharmacy claims data to ensure quality resolutions for members and stakeholders.
Prepare and validate prior authorization requests by obtaining necessary clinical information from providers and prescribers. Triage communications from members and pharmacies while ensuring adherence to HIPAA guidelines and internal procedures.
Perform medication utilization reviews and medical necessity appeals for various client programs. Provide peer-to-peer support to prescribers and contribute to the development of clinical policies and UM criteria.
Develop and productionize multimodal LLMs and AI-based automation tools for healthcare applications such as document understanding and virtual agents. Manage the full ML lifecycle from data pipeline creation and model training to validation and deployment.
Review and make evidence-based decisions on prior authorizations, appeals, and override requests while ensuring regulatory compliance. Provide clinical support and guidance to members, prescribers, and pharmacies via phone.
Responsible for processing first, second level, and external appeals for various lines of business including Commercial, Exchange, and Medicare. The role involves verifying case qualifications, coordinating with pharmacists and medical directors, and communicating with members and providers.
The developer will build and enhance a web-based enterprise health platform by implementing new features and improving existing functionality. This includes writing clean, maintainable code and collaborating with product managers and designers in an Agile environment.
The Senior AI/ML Applied Scientist will investigate and evaluate the latest LLM and MLM models for healthcare applications, develop data pipelines, and productionize machine learning solutions. They will also participate in the complete lifecycle of ML model development and ensure compliance with healthcare data regulations.