Role Overview :
We are seeking a Machine Learning Engineer specializing in Classic ML algorithms to drive healthcare claims analytics and forecasting. This role requires hands-on experience in building, optimizing, and deploying ML models, with expertise in classification, risk prediction, and claims-based forecasting.
Key Responsibilities :
- Develop and deploy Classic ML models to solve key business challenges in healthcare claims processing and analytics.
- Own the full model lifecycle - from data ingestion and preprocessing to real-world deployment and monitoring.
- Specialize in Classic ML algorithms such as XGBoost, Decision Trees, Logistic Regression, Clustering, and Gradient Boosting for classification and forecasting applications.
- Apply time series forecasting, survival analysis, Cox models, and propensity score matching to optimize claims processing, provider reimbursements, and patient adherence predictions.
- Design scalable ML architectures, integrating structured / unstructured claims data (Optum, MarketScan, CMS, EHR).
- Optimize models for production, ensuring interpretability, efficiency, and compliance with healthcare regulations (HIPAA, CMS, OMOP CDM, NICE, ICER, SAP, FDA).
- Work closely with data engineers and healthcare domain experts to integrate models into real-time pipelines and dashboards.
- Ensure continuous model monitoring, retraining, and optimization based on evolving claims patterns and business needs.
Required Skills & Qualifications :
Classic ML Expertise : Boosting techniques, Regression models, Clustering algorithms, Forecasting (Time Series, Cox models).Programming : Proficiency in Python, SQL for ML model development, feature engineering, and automation.Healthcare Claims Analytics : Experience working with structured claims datasets (MarketScan, Optum, CMS, EHR, HealthVerity).Data Processing & Pipelines : Strong knowledge of ETL workflows, healthcare data processing, and statistical modeling.Visualization & Business Impact : Expertise in Power BI, translating ML-driven insights into actionable dashboards.Cloud & Deployment : Experience with AWS / Azure / GCP for ML model deployment and API integration.Operational Optimization : Ability to align Classic ML models with efficiency improvements, claims fraud detection, and provider performance Qualifications :Experience in healthcare risk modeling, claims-based fraud detection, or predictive analytics for patient outcomes.Expertise in regulatory compliance analytics (OMOP CDM, NICE, ICER, SAP, FDA, CMS guidelines).Previous work in healthcare analytics startups, payers, providers, or claims processing companies is a plus.ref : hirist.tech)