Lead ML/AI Engineer

TailorCare
United States

Who this role is best for

Strong fit for senior ML engineers with experience in healthcare and real-time decision systems who lead technical design and production standards.

Best fit for

  • Senior ML engineers with a track record in healthcare decision systems and real-time production pipelines
    — “prescriptive systems in production: recommendation, decisioning, prioritization, or experimentation platforms”
  • Candidates with leadership experience in MLOps and a focus on cost-to-serve and model governance
    — “define per-model and per-decision budgets for compute, streaming, inference, and LLM spend”
  • Individuals who have built event-driven systems with schema management and can handle PHI compliance
    — “event-driven, real-time integrations between model output and the systems that act on it”

Things to consider

  • Travel is required, with up to 10% of time spent on site for meetings and collaboration
    — “Ability and willingness to travel up to 10% as needed for onsite meetings”
  • The role requires working across multiple teams with strict collaboration and integration expectations
    — “work closely with data science, data engineering, software engineering, medical economics”

How to stand out

  • Highlight experience in building prescriptive systems and their measurable impact on outcomes
    — “built systems that decide actions and prove they paid off”
  • Demonstrate leadership in setting engineering standards and mentoring teams
    — “Own engineering standards for the team: code review, automated testing”
  • Emphasize production experience with AWS and Databricks, especially in healthcare contexts
    — “Production experience with AWS data and ML services and infrastructure as code”
  • Showcase hands-on work with event-driven systems and schema management tools
    — “event-driven or streaming systems (Kinesis, Kafka, or equivalent) with schema or contract management”
  • Demonstrate expertise in ML cost control and performance metrics for decisioning systems
    — “make cost a release criterion alongside latency and accuracy”
Pace · Fast PacedCollaboration · HighAutonomy · MediumDecision Impact · Team

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • Developed and maintained a robust decisioning platform
  • Ensured cost-effective and reliable ML systems in production
  • Collaborated with cross-functional teams to integrate ML/AI into business processes
Typical background
Experience in ML/AI engineering or similar rolesStrong background in software engineering and data science

Skills & requirements

Required

Ml/ai EngineeringDecisioning SystemsReal-time Streaming PipelinesProduction Standards For ML ModelsCost Optimization For ML Systems

Preferred

Experience With Databricks And AWS Services

Stack & domain

Ml/ai SystemsDecisioningStreaming PipelinesVersioned SchemasContractsCost-to-serve StandardProduction ROI CalculationModel RegistryAlertingDriftCoverageCalibrationInfrastructure As CodeIAMSecure Data HandlingContainerized InferenceManaged Foundation-model ServicesLLM PipelinesAgentic WorkflowsEvaluationRetrievalGuardrailCost ControlsCode ReviewAutomated TestingReproducibilityDocumentationRelease DisciplineDesign ReviewsArchitecture DecisionsSystem DesignProduction PracticeCommunicationCollaborationProblem-solvingCustomer DiscoveryData AnalysisTechnologyAIMLHealthcare

About the role

Original posting from TailorCare via Greenhouse

About the Role

TailorCare's Data Science team builds the ML/AI systems that decide which patients we reach, when, and how. We are shipping a portfolio of models and a real-time decision platform that puts them to work across every market we serve and learns from every outcome it touches. Model outputs become events, events reach care teams and payer systems, outcomes come back days later, and every piece has to be versioned, replayable, monitored, and affordable under PHI controls. This role owns the engineering that makes that work in production.

As Lead ML/AI Engineer, you will be the technical lead for the platform that turns model output into action. You will set the engineering standards for our decisioning, streaming, and ML release systems, stay hands-on in the highest-risk components, and hold releases to a production bar through design and code review. You will own how our Databricks lakehouse and AWS-native services fit together as the platform evolves. We are looking for someone who has built systems that decide actions and prove they paid off, not just models that predict. This is a senior individual contributor role. Reporting to the Director, AI & Decision Intelligence, you will work closely with data science, data engineering, software engineering, medical economics, clinical, and operations partners.

Primary Responsibilities

Own the decisioning and feedback layer between score and action: action selection and ranking, holdout and experiment assignment, outcome capture, the production ROI calculation, and the pipelines that measure lift per action and channel.

Own the engineering implementation, auditability, and reproducibility of the production savings calculation, in partnership with medical economics and data science, who own the methodology.

Set the design for event-driven, real-time integrations between model output and the systems that act on it: streaming pipelines, versioned schemas and contracts, replay, ordering, idempotency, and failure handling. Own the contracts with partner teams.

Set the cost-to-serve standard for the platform: define per-model and per-decision budgets for compute, streaming, inference, and LLM spend, and  make cost a release criterion alongside latency and accuracy.

Define the production bar for ML models and hold releases to it: CI/CD, model registry, alerting, drift, coverage, and calibration by cohort, market, and payer. Engineer the promotion gate a model or ranking must pass before it goes live.

Own the target architecture and technical roadmap for our AWS-native footprint alongside our Databricks lakehouse, including  infrastructure as code, IAM and secure data handling, containerized inference, and managed foundation-model services under PHI controls.

Set technical direction and production standards for our production GenAI applications, including LLM pipelines and agentic workflows, with the evaluation, retrieval, guardrail, and cost controls needed to run them safely on patient data.

Partner with data scientists on modeling and measurement methodology, with medical economics on how savings is defined, and with data and software engineering on shared pipelines, interfaces, and contracts.

Own engineering standards for the team: code review, automated testing, reproducibility, documentation, and release discipline. Lead design reviews, document architecture decisions, and mentor engineers and data scientists on system design and production practice.

Represent the team's technical position with R&D leadership, finance, and clinical and operations partners.

Other duties as assigned

Qualifications

Required

Bachelor's degree in Computer Science, Engineering, or a related field, or equivalent experience.

8+ years in ML engineering, MLOps, or software engineering, including 4+ years operating ML systems in production and 2+ years as the technical lead or architect of a production ML or decisioning system.

Demonstrated experience building or operating prescriptive systems in production: recommendation, decisioning, prioritization, or experimentation platforms that allocate a constrained resource against a measured outcome.

Production experience with AWS data and ML services and infrastructure as code (Terraform, CDK, or CloudFormation).

Production experience with Databricks, PySpark, Delta Lake, MLflow, or equivalent.

Hands-on experience designing and running event-driven or streaming systems (Kinesis, Kafka, or equivalent) with schema or contract management.

Strong Python and SQL, and hands-on experience running ML workloads in production: training pipelines, model serving, feature systems, or ML platform tooling.

CI/CD for ML workloads and model and pipeline monitoring, including calibration across heterogeneous populations.

Track record of setting engineering standards and raising the bar on a team through review and mentorship.

Ability and willingness to travel up to 10% as needed for onsite meetings, team collaboration, and company events.

Ability and willingness to travel up to 10% as needed for onsite meetings, team collaboration, and company events. 

Preferred

Building and evaluating ML models with scikit-learn, XGBoost, or PyTorch.

Healthcare economics or value-based care exposure: savings methodology, attribution, payer contract constraints.

dbt and lakehouse data modeling.

Healthcare data (claims, pharmacy, eligibility, prior authorization, EHR) and PHI handling requirements.

Uplift modeling, bandit or sequential decisioning, or holdout-based measurement in production.

Containerized model serving and staged or canary deployment patterns.

Amazon Bedrock or other managed foundation-model platforms under a HIPAA BAA.

Agentic frameworks and retrieval systems in production.

Experience building or operating LLM-based applications, including evaluation and guardrails.

Skills 

Engineering Mentality – Finds the common denominator across work and builds the platform that makes the next model faster and safer to ship than the last.

Scientific Approach – Treats a design as a hypothesis, instruments it, and changes course when the data says so.

Seek Simplicity – Builds with the minimum necessary complexity and designs for the person who maintains it next.

Ownership – Takes a system from design to production to monitoring and answers for whether it works in the market, not just whether it shipped.

Collaborative – Works across data science, data engineering, software engineering, medical economics, clinical, and operations to agree on interfaces and hold to them.

Good Communication – Explains what a system does, what it costs, and why it matters in terms a care team or finance partner can act on.

What's In It For You

Meaningful Work: We are dedicated to our mission and deeply value our patients and each other. Each day offers the opportunity to make a positive impact.

Work Environment: We operate as a remote-first company with options for a hybrid work model in Nashville.

Time Off: Our generous paid time off (PTO) and holiday plans ensure you have ample time to rest and recharge.

Family First: We offer paid parental leave and support a healthy work-life balance, encouraging flexibility and autonomy. We love talking about our family and pets! 

Comprehensive Benefits: From Day 1, employees enjoy medical, dental, vision, life, and disability insurance, wellness resources and an employer HSA contribution.

Fair Compensation: We are committed to equitable pay for all team members and support your future goals with a 401k plan that includes employer matching.

Community: We foster an inclusive environment where you can rely on your teammates, share honest feedback, and feel comfortable being your authentic self at work each day. 

TailorCare seeks to recruit and retain staff from diverse backgrounds and encourages qualified candidates to apply. TailorCare is an equal opportunity employer and does not discriminate on the basis of age, sex, gender identity/expression, sexual orientation, color, race, creed, national origin, ancestry, religion, marital status, political belief, physical or mental disability, pregnancy, military, or veteran status.

Source: TailorCare careers (Greenhouse)

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