Jobs at Collective Health

Owner of quality for an LLM-based multi-agent claims adjudication pipeline. Build evaluation frameworks, automated LLM-grading workflows, function-call and reasoning-trace auditing using Vertex AI. Integrate CI/CD regression, Auto-SxS comparisons, and large-scale mocking to ensure compliance and accurate adjudications for DOL/DOI audits.

Lead and modernize the healthcare analytics function, build automated client reporting infrastructure, drive claims and member data analysis, implement metric governance and data quality, leverage LLMs/RAG for AI-informed insights, partner with cross-functional teams and clients, and hire and develop a high-performing analytics team while ensuring HIPAA compliance.

Lead design and implementation of agentic AI systems for claims adjudication using Gemini and Vertex AI. Build production-grade Python agents, implement RAG, grounding, stateful orchestration with human review, input/output guardrails, and Google Cloud DLP integration. Drive backend patterns, optimize model behaviors, and supervise fine-tuning to ensure reliable, auditable outputs in healthcare claims workflows.

Own and develop Provider Servicing backend systems: design scalable, secure Java/Spring Cloud microservices and integrations (Mulesoft), build APIs and data services, adopt AI developer tools, mentor engineers, collaborate cross-functionally, and automate operations to improve SLAs.

Partner with senior leaders to design and implement people strategies for non-exempt and exempt teams, drive workforce planning, performance and compensation cycles, lead change management, diagnose culture using engagement data, coach leaders on complex employee relations and performance issues, and collaborate with ER, Legal, and People Operations to deliver fair, compliant solutions that support retention and business outcomes.

Lead and mentor a small product team to define and execute the product vision and roadmap for Core TPA Claims. Own strategy for the claims processing engine, ensure high-fidelity adjudication and payment integrity, collaborate cross-functionally (engineering, design, data, sales, ops), and implement product best practices and metrics to deliver compliant, scalable healthcare products.

Serve as the primary analytics lead for top clients, owning end-to-end reporting and complex claims analyses. Provide SQL mentorship, design scalable solutions with Data Engineering, manage roadmap in Jira/Confluence, deliver high-impact presentations, and lead rapid ad-hoc and audit analyses to inform clinical and financial decisions.

Lead and scale the company's procurement function focused on technology spend. Manage end-to-end sourcing, RFPs, vendor selection, contracting, SaaS license management, renewals, and vendor risk. Partner with Legal, Finance, Product, Engineering and Security to ensure compliance (HIPAA, SOC2, BAAs), optimize costs, and implement procurement processes and vendor relationship strategies.

Lead and manage the core Claims processing system, owning development, testing, and maintenance. Partner with Product, Business, Operations, and Support to define and execute the technical roadmap, automate processes, and improve SLAs. Drive adoption of AI-powered developer tools and architect AI-native, agentic solutions. Provide technical and people leadership to build scalable, cloud-native backend services and integrations using Java/Spring Cloud, Kafka, AWS, Kubernetes, PostgreSQL, and BRMS.

Lead FP&A efforts partnering with Finance leadership and cross-functional teams (CX, HPO, Product, Engineering). Drive budgeting, forecasting, scenario and capacity planning, month-end reporting, dashboards, board materials, ad-hoc analysis, long-range planning, and scaling tools/processes to improve financial foresight and decision-making.

Partner with Commercial, Sales, Marketing, and Client Success to lead commercial FP&A: budgeting, forecasting, scenario planning, revenue/pricing management, month-end reporting, dashboards, board materials, long-range planning, and cross-functional financial projects to drive revenue strategy and operational scale.