AI Strategist, Revenue & Cost Management
RemoteHealth OtherPredictive Modelling & MLData Engineering
Role Summary
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Lead AI Strategist role in Clover Health's Actuarial organization focusing on healthcare payer finance. You will design and deploy ML models for revenue optimization (risk adjustment) and claims payment integrity, building anomaly detection, graph analytics, and forecasting systems. Senior technical IC role, remote-first, with a strong emphasis on Python, SQL and production ML experience in a payer setting.
JOB DESCRIPTION SUMMARY
- Lead design and deployment of ML models for risk adjustment and claims integrity
- Build anomaly detection, graph analytics, and time-series forecasting systems
- Work on large-scale healthcare claims and encounter data in a payer setting
- Remote-first, senior technical IC role within the Actuarial organization
- Requires 4+ years hands-on quantitative and production ML experience
DOMAIN EXPERTISE
- Healthcare payer claims and encounters data
- Risk adjustment and encounter analysis
- Claims payment integrity and recovery
- Designing and deploying production ML solutions for finance
KEY REQUIREMENTS
- 4+ years of quantitative, hands-on experience delivering production AI solutions
- 4+ years of domain experience with healthcare payer claims and encounters data
- Expert-level fluency in Python and SQL
- Proven experience implementing and maintaining ML models in production
- Ability to design technical strategy for in-house payment integrity systems
TECH STACK
- No tech stack specified
