Senior AI Engineer - Clinical Reasoning

NxT Level•New York, NY

3d•Hybrid

About The Position

Our client is building AI technology with the mission of making high-quality healthcare more accessible, affordable, and scalable. Their AI-powered clinical platform already supports millions of patient consultations, and the company is working toward scaling that impact significantly while continuing to improve clinical safety, reasoning quality, accuracy, and trust. This is an opportunity to join a team building real-world clinical AI systems used by patients every day. The company operates in a live healthcare environment, giving the team a unique dataset and feedback loop to test, improve, and deploy AI systems in practical clinical care. Our client is hiring a Senior AI Engineer to help build the next generation of clinical AI systems. This role blends research and engineering. The ideal candidate is not just running experiments or writing notebooks — they are building real systems that reason, retrieve evidence, evaluate performance, and improve over time. You’ll work on agentic reasoning, retrieval, evaluation infrastructure, model learning, and clinical decision support systems. The goal is to help every component of the AI platform become safer, more accurate, more useful, and more trustworthy with each iteration.

Requirements

Strong experience building real AI, ML, or LLM-powered systems
Deep experience in at least two of the following areas: Agentic architectures, reasoning systems, and tool use; Model evaluation, experimentation, and rubric design; Model training, fine-tuning, distillation, or reinforcement learning; Search, ranking, retrieval, RAG, or grounding systems
Strong ML fundamentals, including training data, objectives, metrics, failure analysis, calibration, and validation
Ability to work in complex domains where ground truth is incomplete and expert opinions may differ
Strong engineering fundamentals with experience building production systems, not just research prototypes
Clear communication and strong collaboration across engineering, clinical, and product teams
Ability to think through business impact and prioritize technical work accordingly
Comfort operating with autonomy in a builder-first environment

Nice To Haves

Published research, patents, meaningful open-source contributions, or novel production ML systems
Experience building AI systems at an early-stage or high-growth company
Experience in healthcare, clinical AI, regulated industries, or safety-critical environments
Familiarity with clinical workflows, healthcare data, HIPAA, FHIR, EHR systems, or HL7
Experience with human-feedback systems, RLHF, simulations, or synthetic data generation
Experience with AI safety, bias detection, calibration, fairness, or model reliability

Responsibilities

Design and build agentic clinical reasoning systems
Develop AI architectures that support reasoning, reflection, verification, tool use, routing, uncertainty handling, and escalation
Build systems where specialized agents and models work together to support safe and reliable clinical decisions
Create evaluation platforms, rubrics, simulations, and experiments to measure AI performance in clinical use cases
Identify whether improvements should come from reasoning, retrieval, model behavior, data, or engineering changes
Apply methods such as fine-tuning, distillation, reinforcement learning, preference optimization, and prompt or system optimization
Build training data, feedback, reward, and experimentation pipelines
Develop search, ranking, retrieval, and grounding algorithms tied to trusted medical evidence and patient context
Improve retrieval systems based on their impact on downstream clinical decisions, not just document relevance
Own problems end-to-end, from framing and experimentation through shipping and measurement
Collaborate closely with engineering, clinical, product, and physician-scientist partners