[Hiring] Senior ML/LLM Engineer @U.S. Renal Care

Role Description

US Renal Care is expanding its Clinical Intelligence and Workflow Automation capabilities to support clinicians, reduce administrative burden, and improve patient outcomes. We are seeking a Senior ML/LLM Engineer to design and implement advanced AI systems that power intelligent decision support, workflow automation, and real‑time clinical insights. This role focuses on building agentic AI systems, Retrieval-Augmented Generation (RAG) pipelines, and scalable ML infrastructure that integrates seamlessly with EHR systems, clinical workflows, and operational platforms across the organization.

The Team Member will collaborate with clinicians, product leaders, and engineering teams to deliver safe, reliable, and high‑impact AI solutions.

• Design and implement AI Agents using frameworks such as LangGraph, Semantic Kernel, or custom orchestration layers.
• Build and maintain RAG pipelines grounded in clinical guidelines, evidence-based medicine, and real-time patient data.
• Develop systems that synthesize fragmented clinical data (EHR, labs, imaging, notes) into prioritized insights for clinicians.
• Architect scalable inference services capable of low-latency performance in clinical environments.
• Create evaluation frameworks to ensure AI outputs are clinically accurate, unbiased, and aligned with source-of-truth medical records.
• Implement vector search infrastructure using Pinecone, Milvus, or equivalent technologies.
• Perform fine‑tuning, PEFT/LoRA training, and model optimization for production workloads.
• Build high-performance backend services using C#/.NET to integrate AI systems with existing clinical platforms.
• Ensure all AI systems comply with HIPAA, data privacy requirements, and internal security standards.
• Research emerging AI technologies and apply them to improve clinician productivity and patient care.
• Mentor and support other engineers in AI-LLM/ML best practices.
• Participate in code reviews and contribute to consistent engineering standards.
• Collaborate with cross-functional teams to translate clinical workflows into automated, intelligent systems.
• Regular and reliable attendance is required for the job.

Qualifications

• Bachelor's degree preferred
• 5 years of professional experience in ML/LLM engineering, including production-grade systems
• Deep experience with LLM orchestration, tool-calling, and long-context document handling
• Strong proficiency with vector databases (Pinecone, Milvus, Weaviate)
• Experience with MLOps: Docker, Kubernetes, CI/CD, model deployment
• Understanding of HIPAA, PHI handling, and clinical data privacy a plus but not mandatory
• Proficiency with C#/.NET for backend service development
• Familiarity with healthcare interoperability standards (FHIR, HL7)
• Experience designing scalable, low-latency inference systems
• Strong understanding of data modeling and workflow mapping
• Experience with automated testing, unit tests, and evaluation frameworks
• Proficient understanding of version control tools (Git, TFS)
• Experience with JIRA for task tracking
• Analytical mindset with strong problem-solving skills
• Experience with AI development tools (e.g., Cursor, Copilot)
• EHR/HealthCare claims domain knowledge a plus but not mandatory
• Proficient understanding of code versioning tools (e.g. ADO)
• Experience with JIRA to enable tracking of development tasks
• Should be analytical and have good problem-solving skills