The Director of AI & ML is responsible for establishing and leading the AI function, defining AI strategy, building a high-performing team, and delivering production-grade ML and AI solutions within healthcare payer workflows.
Role Overview & Scope
Care Lumen is building an AI-first healthcare platform serving complex payer workflows across Care Management, Utilization Management, and LTSS.
We are seeking a Director of AI & Machine Learning to establish and lead our ML & AI function from the ground up. This is a foundational leadership role responsible for defining our AI strategy, building a high-impact team, and delivering production-grade ML and AI capabilities embedded directly into core payer workflows.
This leader will sit at the intersection of Engineering, Product, Clinical Operations, and Data — translating real-world healthcare complexity into safe, scalable AI systems that measurably improve automation, accuracy, and clinical efficiency.
This is not a research role. It is a production AI leadership role focused on delivering real, regulated, enterprise-grade systems. The ideal candidate is a builder-operator, not a pure data scientist and not an AI evangelist.
Leadership Profile
The ideal candidate is:
- Strategically minded but execution-oriented
- Comfortable with ambiguity and building from zero
- Equally credible with engineers and executives
- Passionate about responsible AI in high-stakes domains
- Motivated by building long-term enterprise value and capability, not short-term experiments
- Team-focused
- Comfortable in a leadership role
- A frequent and effective communicator
Key Responsibilities
1. AI Strategy & Architecture
- Define and execute a multi-year AI roadmap aligned to product evolution and regulatory constraints (CMS, Medicaid, HIPAA, NCQA).
- Architect scalable ML and generative AI systems embedded in software products.
- Evaluate and select appropriate model strategies (predictive models, RAG pipelines, fine-tuned LLMs, reasoning models, agentic workflows).
2. Build & Lead the AI Function
- Recruit and develop a small (4 to start), experienced team of ML engineers and applied AI specialists.
- Establish experimentation standards, prompt engineering practices, evaluation benchmarks, and model lifecycle processes.
- Create a culture of pragmatic, production-focused AI engineering.
3. Production AI Delivery
- Deliver end-to-end ML/AI solutions, including:
- Risk prediction models
- Intelligent document summarization
- RAG-based or knowledge-graph-based systems
- Fine-tuned LLM applications
- Agentic automation workflows
- Ensure solutions are measurable, reliable, and embedded into production workflows.
4. MLOps & Governance
- Establish robust MLOps pipelines (training, validation, deployment, monitoring).
- Implement model observability, drift detection, and performance monitoring.
- Partner with Security and Compliance to define responsible AI standards (fairness, bias evaluation, explainability, audit trails).
- Design PHI-safe AI environments and secure data pipelines.
5. Cross-Functional Leadership
- Partner with Product and Clinical leaders to identify high-value AI use cases.
- Translate complex AI concepts into executive-ready business cases.
- Guide organizational AI literacy and responsible adoption.
Skills, Knowledge & Expertise
- BS in Computer Science, Data Analytics, ML/AI, or related field.
- Minimum 10+ years in ML/AI engineering or applied data science
- Minimum 4+ years leading teams or building AI functions in a Senior Manager or Director role
- Proven track record delivering production ML, generative AI, and/or agentic systems at scale.
- Demonstrated experience with relevant frameworks and patterns, e.g.,
- Model evaluation and benchmarking
- LLM fine-tuning (e.g., LoRA, instruction tuning)
- RAG and/or KG architectures
- Agentic systems & workflows
- HuggingFace ecosystem
- PyTorch / TensorFlow
- MLOps (CI/CD for ML, monitoring, versioning)
- Experience deploying and running ML/AL in cloud-native environments (AWS preferred)
- Demonstrated experience applying governance and guardrails to AI and agentic systems
- Strong understanding of regulated data environments (healthcare preferred)
What’s Preferred
- Masters of PhD in Computer Science, Data Analytics, ML/AI, or related field
- Agentic AI framework experience (LangGraph, CrewAI, or similar)
- Experience building AI platforms in PHI-safe or regulated environments
- Knowledge of FHIR APIs and healthcare ontologies (SNOMED, LOINC)
- Experience building AI Centers of Excellence or practice areas
- Healthcare payer domain expertise (UM, CM, risk scoring, prior authorization)
- Familiarity with CMS and Medicaid compliance considerations
What Success Looks Like (First 18–24 Months)
- AI roadmap aligned to product strategy and regulatory realities
- Built and retained a high-performing ML/AI team
- Production deployment of multiple ML/AI/LLM-powered features
- Implemented MLOps platform and model governance framework
- Demonstrated measurable operational impact (e.g., reduced manual review time, improved prediction accuracy, workflow automation gains)
- Responsible AI framework implemented with auditability and explainability
Compensation & Benefits
The expected total cash compensation for this role is market-driven, with an expected starting salary of $210,000 - $275,000 with up to 15% bonus. Salary is ultimately determined based on a candidate’s skills, expertise, and experience.
Care Lumen offers a robust and comprehensive benefits package including:
- Remote-first environment with company provided computer
- Thirteen paid holidays per year (average)
- Medical, dental and vision coverage with multiple levels of coverage
- HSA, FSA and Dependent Care accounts
- Short-term and Long-term disability
- Life and accidental death insurance
- Discounted voluntary benefits, such as additional life insurance
- Employee Assistance Program
- Paid Parental Leave
- Flexible vacation time
- 401(k) with employer matching and immediate vesting
Offers are contingent upon successful completion of a background screening. Background screenings will be conducted in compliance with applicable laws and will not be initiated without your consent.
Care Lumen is an equal opportunity employer committed to building a diverse and inclusive workplace. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other legally protected status.
We are committed to providing reasonable accommodations to qualified individuals with disabilities in our job application process. If you need assistance or an accommodation due to a disability, please contact us at [email protected].
About Care Lumen
Care Lumen is transforming healthcare by connecting people, care, and data—so that every decision leads to better outcomes. We empower care teams with a unified platform that delivers intelligent, real-time insights, streamlined workflows, and stronger collaboration across clinical, operational, and administrative domains.
Our vision is bold: to reimagine how care is delivered by unifying clinical operations and unlocking insights that improve lives. We believe in the power of great people and purposeful technology—and with all of us aligned around a common goal, our potential grows even stronger. We’re building for impact today and evolving through innovation tomorrow.
We’re a remote-first company that values flexibility, autonomy, and results over hours logged. We’re guided by values that push us to excel, stay curious, and take smart risks. The best solutions come from teams that listen, learn, and build together. And we’re focused on outcomes that matter—not just for our clients, but for the people they serve.
Care Lumen’s LinkedIn
Care Lumen’s website
Process – What to Expect
Our hiring process typically includes:
- Applied
- Recruiter Interview
- Hiring Manager Interview
- Second Hiring Manager Interview
- Panel Interview
- Second Panel Interview
- Offer
- Background Check
- Hired – Welcome to Care Lumen!
About
Newfire Global Partners is a leading custom software development company that specializes in working on complex problems. With a strong focus on meeting the unique needs of each organization, they connect clients with local leaders and trusted remote teams to deliver exceptional IT services and software development solutions. Their range of expertise spans various domains, including Data & Analytics, AI/ML, Software Engineering, Product Management, and Marketing. By leveraging recent innovations in artificial intelligence, Newfire Global Partners ensures that their clients can transform the new normal into a competitive advantage. Through their advisory services, experienced leaders guide businesses through transformations and de-risk operations throughout the entire lifecycle. They also offer talent augmentation, bringing together highly skilled professionals from multi-disciplinary teams to support software, product, and marketing needs. Newfire Global Partners is committed to providing excellent service and driving client growth. Their team of industry experts works closely with organizations, whether it's driving transformation, building from scratch, or getting things done efficiently. Trusted by VC & PE firms, established businesses, and startups, Newfire Global Partners is proud to be a reliable partner in various industries, including healthcare, enterprise, and fintech. Partner with Newfire Global Partners today and unlock the expertise that accelerates success.
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