AI / ML Python Developer

This role supports the Medicaid Enrollment and Member domain, where accurate and timely data processing is critical. The team manages complex workflows involving HIPAA files received from state agencies, which are loaded into the member book of records. These files often require rapid correction due to downstream impacts-such as mass member terminations affecting insurance card validity.

A key component of this role involves maintaining and improving an existing anomaly detection system. Anomaly detection is a technique used in data analysis and machine learning to identify patterns or events that deviate significantly from the norm. These "anomalies" or "outliers" can indicate critical issues such as fraud, system failures, data errors, or unexpected behavior.

In the Medicaid context, anomaly detection helps flag irregularities in member data-like when a state mistakenly sends a file that terminates 25,000 members in a single day. Detecting such anomalies early can prevent downstream impacts, such as invalid insurance cards or disrupted services.

Key concepts include :

• Normal vs. Abnormal Behavior : The system learns what typical data looks like and flags anything that doesn't fit.
• False Positives : Sometimes the system flags something as abnormal when it's actually fine-this is a common challenge.
• Feedback Loops : These are used to improve the model by learning from past mistakes (e.g., reducing false positives).
• Machine Learning Models : Algorithms like isolation forests, autoencoders, or statistical models are often used to detect anomalies.

You will take ownership of the anomaly detection solution built by the enterprise team, evaluate its performance, and determine whether to enhance or rebuild it. The role also includes integrating this solution into the production environment and ensuring it aligns with the team's operational goals.

Primary Responsibilities

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Required Skills & Experience

Nice to Have Skills & Experience

o .NET, ASP.NET, WCF services, Angular (for integration purposes)

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and / or other paid time off as provided by applicable law.