About The Position
We are seeking an NLP Engineer with strong automation expertise to design and implement intelligent solutions that read, interpret, and operationalize CMS manuals and regulatory guidance. The role focuses on leveraging NLP and LLMs to extract rules, conditions, exceptions, and compliance logic from complex structured and unstructured CMS documentation, and automating downstream workflows using Python and enterprise automation platforms.
Requirements
- Strong experience with NLP and LLM frameworks (e.g., spaCy, Hugging Face, Azure OpenAI/OpenAI).
- Proven hands-on expertise in Python for text processing, rule extraction, and workflow automation.
- Experience with Document Intelligence / IDP platforms and techniques.
- Practical experience with UiPath, Power Automate, or similar enterprise automation tools.
- Demonstrated ability to process and interpret complex regulatory and policy documents.
- Experience building production-grade AI solutions in regulated industries.
- Requires US residency of 3 years and subject to CMS background Checks
Nice To Haves
- Prior experience working with CMS manuals, healthcare regulations, or payer/provider policy documentation.
- Healthcare domain experience (Medicare, Medicaid, RADV, HCC, payment integrity, utilization management).
- Familiarity with agentic AI, rule engines, or decision orchestration frameworks.
- Cloud experience (AWS preferred).
Responsibilities
- Design and build NLP/LLM-driven pipelines to read and interpret CMS manuals, policies, and regulatory guidance.
- Extract rules, conditions, exceptions, and eligibility logic from unstructured and semi-structured CMS documents (PDFs, HTML, Word, policy manuals).
- Implement Document Intelligence / Intelligent Document Processing (IDP) solutions for large-scale CMS content ingestion.
- Convert extracted regulatory logic into machine-readable rules and automated workflows.
- Develop and productionize automation using Python and workflow orchestration tools such as UiPath and Power Automate.
- Collaborate with clinical, compliance, actuarial, and engineering stakeholders to validate rule interpretations and ensure accuracy.
- Ensure outputs are traceable, auditable, and aligned with CMS compliance standards.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
