Description
We're looking for our next bold leader –
Head of Applied AI Research
– to join our quest to provide market-transforming solutions for businesses, care teams and consumers to interactively manage health and care.
About Medecision
Medecision is a leading healthcare SaaS platform helping health plans, providers, and members move from data to doing. Our platform powers utilization management, care management, quality, and risk programs for millions of members across the U.S.
Now, we are expanding our innovation with Medecision AI — an integrated initiative to embed agentic AI, predictive insights, and automation into every workflow. To lead this effort, we are creating a Center of Excellence (CoE) for AI that will shape the future of payer operations and clinical decision support.
Role Overview
We are seeking a visionary Head of AI Center of Excellence to build and lead Medecision's AI strategy, talent, and innovation engine. This leader will establish Medecision AI as a trusted, scalable, and ethical capability that enhances our core platform and unlocks new opportunities in clinical operations, member engagement, and medical cost savings.
The Head of AI CoE will balance innovation and execution—driving cutting-edge research, embedding AI in product lines, and ensuring regulatory, ethical, and operational rigor.
Are you ready? We are Join us in our journey to innovate solutions that solve real problems and partner with our clients to transform healthcare.
Location: Remote (US based)
Reports to: CEO (with strong partnership with CTO and Chief Product Officer)
Requirements
Key Responsibilities
* Strategy & Leadership
* Define and lead Medecision's enterprise AI strategy in alignment with the company vision.
* Build and manage the AI CoE as a high-performing, multidisciplinary team (data science, ML engineering, AI ethics, clinical informatics).
* Act as the external face of "Medecision AI" at conferences, publications, and partnerships.
* Innovation & R&D
* Drive applied research in agentic AI, LLMs, and predictive modeling for payer/provider use cases.
* Create a structured process for piloting, scaling, and productizing AI innovations across UM, CM, Quality, and Risk products.
* Partner with academic, vendor, and open-source AI communities to stay ahead of the curve.
* Operational Excellence
* Establish governance, compliance, and bias-mitigation frameworks for AI in healthcare.
* Build reusable AI/ML infrastructure (vector DBs, orchestration, monitoring, MLOps).
* Ensure AI models are explainable, auditable, and aligned with payer/provider regulatory requirements.
* Collaboration & Influence
* Partner with Product GMs and Engineering leaders to embed AI pods into each line of business.
* Work closely with Clinical and Compliance teams to validate AI models against industry guidelines (e.g., InterQual, MCG, CMS).
* Evangelize AI internally, building a culture of adoption and responsible innovation.
Qualifications
* 12+ years of experience in AI/ML, data science, or advanced analytics, with at least 5 in leadership roles.
* Proven track record building and scaling AI capabilities within healthcare, life sciences, or regulated industries.
* Deep expertise in applied AI/ML, including large language models (LLMs), RAG, NLP, predictive analytics, and MLOps.
* Strong knowledge of healthcare workflows (UM, CM, claims, risk adjustment, quality measures).
* Demonstrated ability to recruit, inspire, and lead world-class AI talent.
* Excellent communication skills; ability to translate complex AI concepts into business outcomes.
* Passion for improving healthcare outcomes and reducing costs through innovation.
Why Join Medecision AI
* Impact at Scale: Shape how millions of members experience care through intelligent automation.
* Innovation Culture: Lead a greenfield AI initiative inside an established healthcare SaaS leader.
* Talent Magnet: Build the most visible AI team in the payer space.
* Mission Driven: Apply your skills to bend the cost curve, improve access, and enhance quality of care.
Salary Description
Salary based on experience. Base plus bonus