Principal / Expert Agentic AI Architect

Principal / Expert Agentic AI Architect — Health Insurance (Expert)

You'll architect large-scale autonomous AI ecosystems that power intelligent decision-making across underwriting, claims, and fraud prevention. You'll define the blueprint for explainable, governed, and compliant Agentic AI across the enterprise.

Key Responsibilities:

• Architect enterprise-grade agentic systems for end-to-end claims automation, risk scoring, and policy management.
• Build multi-agent collaboration frameworks for cross-functional reasoning (e.g., Claim Agent + Fraud Agent + Underwriting Agent).
• Implement governance and safety layers enforcing compliance (PHI masking, access controls, explainability).
• Integrate knowledge graphs with RAG pipelines to link medical ontologies (SNOMED, ICD-10, CPT).
• Design self-reflective agents capable of error correction, justification, and escalation to human adjusters.
• Oversee data lineage, observability, and versioned reasoning for auditable AI.
• Partner with actuarial and data science teams to integrate predictive models into reasoning agents.
• Lead teams in developing trustworthy, explainable AI within HIPAA and SOC 2 frameworks.

Technical Skills:

• 8+ years of experience in AI systems or enterprise architecture, with 3+ in LLM/agentic AI.
• Expert in LangGraph, Semantic Kernel, Autogen, or custom orchestration frameworks.
• Deep understanding of health insurance workflows: claims lifecycle, enrollment, policy underwriting, utilization review.
• Strong foundation in knowledge graphs, vector search, and ontology-based retrieval.
• Experience integrating FHIR servers, EHR APIs, and data pipelines.
• Hands-on with cloud-native architectures (Azure Health Data Services, AWS HealthLake).
• Proven record of designing AI governance frameworks, audit trails, and ethical controls.

Preferred: contributions to open-source AI, whitepapers, or regulatory AI committees.