Jobs at Machinify

Provides legal counsel for pharmacy Coordination of Benefits operations, advising on federal and state laws, CMS guidance, contracts, compliance, risk mitigation, disputes, settlements, and litigation. The attorney reviews operational matters, trains pharmacy staff, supports client inquiries, coordinates with outside counsel, communicates regulatory developments, and collaborates with compliance, operations, and PBM teams. The role also includes negotiation with PBMs and employer benefit managers and participation in industry conferences.

Design, build, and operate production data pipelines using Python, Spark SQL, and Airflow. Canonicalize healthcare and customer data into trusted internal models, optimize distributed processing, enforce schemas, and implement quality checks and observability. Support customer onboarding, streaming pipelines, troubleshooting, on-call operations, and platform best practices while collaborating with product, analytics, engineering, data science, and customer teams.

Supervises remote clinical audit staff and manages audit quality, productivity, inventory, staffing, and service-level performance. Performs clinical audits and quality assurance reviews, resolves rebuttals, supports appeals, identifies cost-saving opportunities, and ensures adherence to medical review guidelines. Provides coaching, training, performance management, reporting, and operational support while collaborating with management, HR, clients, and other departments. Requires nursing licensure, extensive healthcare claims and coding expertise, medical record auditing experience, and supervisory leadership.

Lead and transform the QA function for an AI-accelerated software organization. Define technical quality strategy, CI/CD gates, test-data approaches for PHI, and automation across unit, integration, and end-to-end testing. Build and grow a high-performing quality engineering team, set release standards and exit criteria, integrate AI/LLM evaluation with MLEs, and provide auditable metrics for leadership and regulators.

The Software Architect will design and implement intelligent document processing and agentic evaluation frameworks, leading architectural direction and coding in Python and Scala/Java.

The Product Marketing Manager will support messaging and positioning, develop customer insights, create marketing assets, assist in product launches, and enable sales efforts.

Lead healthcare payment integrity analyses, collaborate with clients and internal teams, build and maintain large-scale SQL and Spark queries, design ETL/ELT transformations, implement AI/LLM-driven analytical workflows, perform data quality monitoring, and mentor analysts while documenting lineage and audit-ready methodologies.

Provide legal support and guidance to subrogation operations, advise General Counsel, review files and potential adverse suits, train and guide analysts, and communicate impacts of new court decisions, statutes, and regulations to the recovery team.

Design and build scalable web applications, collaborate on product direction, and implement complex systems using ML techniques, ensuring software quality.

The Senior Director leads government business development, focusing on federal and state markets, driving contract wins and building strategic partnerships. Responsibilities include managing the business development pipeline, influencing policy, and representing the company at industry events.

Lead and scale Machinify’s pharmacy operations organization, overseeing managers and driving performance, culture, and continuous improvement. Optimize workflows, reduce manual effort, establish productivity and recovery targets, use operational data to diagnose issues, and partner with engineering on automation. Own strategic initiatives, performance management, workforce planning, and cross-functional execution while representing the company with clients, prospects, and executive leadership.

Manage document workflows, process and quality-check incoming claims, assign statuses, route files, reconcile balances, validate charges, resolve discrepancies, and perform itemized bill data entry. Monitor file intake, output, and file-sharing accuracy; report system issues through service tickets; analyze document and claims trends; and communicate operational updates across teams. The role requires strong attention to detail, organization, analytical thinking, and proficiency with office and document-management tools.

Lead a 5-6 person engineering team to build a cloud-native, AI-driven Coordination of Benefits product. Own architecture, roadmap, production releases, hiring, coaching, and engineering standards. Collaborate with product, ML, UX, QA, and operations to design rules engines, claims pipelines, and scalable secure systems for regulated healthcare data.

Staff-level platform engineer to improve and scale inherited Scala systems, redesign data layers for ML/AI, build a Rust service framework, enhance observability and resilience, shape developer tooling and standards, and work across JVM, Rust, Python, SQL, and Spark.

The Sr. Product Manager will oversee the transformation of pharmacy payment integrity through AI automation, design workflows, and collaborate with teams to enhance customer-facing analytics and operational processes.

The Senior Technical Data Product Manager will oversee the data product roadmap, collaborating with data engineering and architecture teams. Responsibilities include assessing legacy systems, developing product roadmaps, driving cross-functional deliveries, and ensuring technical requirements are met, aiming for swift execution and measurable impact.

Own end-to-end client data migrations: reverse-engineer legacy ETL, design and build Airflow DAGs and Spark jobs, validate and reconcile data at scale, document architecture and decisions, and coordinate cross-functional teams through go-live and hypercare.

Lead and grow the AI/ML Engineering team, manage core AI/ML platform development, ensure production-grade service operational excellence, and develop product strategies.

The Data Scientist will build machine learning models to enhance claim audits, optimize performance, and improve healthcare decision-making by analyzing complex data sets.

As a DRG Reviewer, you will conduct DRG payment validation reviews, assess medical records, document findings, and ensure compliance with payment standards.