AI Consultant, Conversational AI (Healthcare - Managed Care)
About The Position
A mission-driven, nonprofit healthcare organization serving Medicaid and Medicare populations is investing heavily in next‑generation artificial intelligence. The organization supports hundreds of thousands of members across California and is expanding digital capabilities to improve provider experiences, reduce call volume, and deliver personalized, accessible care. This role will directly shape the future of AI-assisted provider interactions and drive measurable impact across the healthcare ecosystem. We are seeking an experienced AI Consultant specializing in Conversational AI to design, build, and deploy an advanced AI-powered agent for a provider portal. This consultant will collaborate closely with internal engineering and business teams to accelerate delivery, ensure regulatory compliance, and deliver a production-ready solution. This role blends hands-on technical development with deep understanding of healthcare workflows. Bilingual comprehension (English/Spanish) is especially important for serving the provider community effectively.
Requirements
- Hands-on experience with OpenAI APIs and custom GPT development.
- Experience fine‑tuning LLMs for domain-specific use cases.
- Knowledge of multilingual NLP/NLU; Spanish comprehension strongly preferred.
- Familiarity with ASR/TTS technologies.
- Strong experience in Python (preferred) and/or Node.js/JavaScript.
- Experience building RESTful integrations and working with cloud platforms (Azure, AWS, or GCP).
- Knowledge of FHIR/HL7 or other healthcare interoperability standards.
- Understanding of Medicaid/Medicare processes, provider workflows, claims, and authorizations.
- Deep knowledge of HIPAA and secure data handling best practices.
Nice To Haves
- Previous experience implementing conversational AI in healthcare or provider portals.
- Experience in managed care or payer-side systems.
- Experience with MLOps for deploying and monitoring AI models.
- Excellent communication skills for collaborating across technical and non‑technical stakeholders.
Responsibilities
- Architect, develop, and train an LLM-powered chatbot to support provider inquiries (claims status, authorizations, coverage codes, member lookups, etc.).
- Integrate the model with enterprise data systems (e.g., Snowflake, Matillion) and core operational platforms.
- Optimize accuracy, safety, and real-world performance using best‑in-class AI techniques.
- Build conversational flows aligned with healthcare operational processes and provider needs.
- Collaborate with developers, analysts, and SMEs to ensure seamless system integration.
- Implement bilingual support (English + Spanish) for provider-facing interactions.
- Ensure HIPAA-compliant design and secure handling of PHI.
- Document architecture, workflows, and operational guidelines for long-term sustainability.
- Adhere to NDA requirements, and secure/VPN-accessed environments.
Benefits
- Medical, dental & vision
- Critical Illness, Accident, and Hospital
- 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
- Life Insurance (Voluntary Life & AD&D for the employee and dependents)
- Short and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)
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What This Job Offers
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
