Senior AI Software Engineer - Medicare Billing and Care Management Platforms

Overview

We are seeking an experienced Senior AI Software Engineer to design, develop, and maintain a healthcare SaaS application, the CCIQ Platform, focused on Medicare care management programs, including Chronic Care Management (CCM), Remote Patient Monitoring (RPM), Remote Therapeutic Monitoring (RTM), Principal Care Management (PCM), and related reimbursement workflows.

The ideal candidate will have hands-on experience building healthcare applications that support Medicare billing, CPT coding, time capture, patient eligibility, claims generation, EHR integrations, compliance, and provider workflow automation. This role will work closely with Product, Clinical Operations, Billing, and Engineering teams to deliver scalable, secure, and compliant solutions.

Beyond strong technical skills, we value a leadership mindset who can champion AI-driven software development practices, mentor engineers, and help transform the organization s SDLC through effective adoption of AI-enabled tooling and workflows. The ability to influence teams, drive change, and foster a culture of continuous innovation is essential.

• Medicare Billing and Care Management Solutions:
  Design and develop software solutions supporting CCM (99490, 99439, 99491), RPM (99453, 99454, 99457, 99458), RTM (98975, 98976, 98977, 98980, 98981), PCM (99424–99427), Behavioral Health Integration (BHI), Transitional Care Management (TCM), and Annual Wellness Visits (AWV). Implement CMS billing rules, reimbursement logic, eligibility validation, and audit controls. Develop time-tracking and documentation workflows to support compliant billing. Build claim generation and billing reconciliation capabilities.
  
  Collaborate with operations teams to improve billing accuracy and reduce revenue leakage.
• Healthcare Platform Development:
  Design scalable microservices and APIs supporting patient management, billing, and reporting workflows. Build patient risk stratification and population health management capabilities. Develop dashboards for care managers, providers, billing teams, and administrators. Implement workflow automation for enrollment, consent management, care plan generation, and patient outreach.
• EHR and Healthcare Integrations:
  Develop integrations with EHR systems (Epic Systems, athenahealth, AdvancedMD, eClinicalWorks, Next Gen Healthcare). Build interfaces utilizing HL7, FHIR APIs, and CCD/C-CDA. Ensure data synchronization, patient matching, and interoperability compliance.
• Security & Compliance:
  Develop solutions compliant with HIPAA, CMS requirements, SOC 2 controls, and HITRUST frameworks. Implement secure coding practices, audit logging, encryption, and access controls.
• Technical Leadership:
  Mentor engineers, participate in architecture reviews, drive engineering best practices, code quality, testing automation, and Dev Ops maturity. Participate in technical roadmap planning and platform modernization initiatives. Translate regulatory requirements into software capabilities in collaboration with Product and Operations teams. Strong and proven experience in spec-based AI-driven SDLC using tools such as Claude Code, Augment Code, Cursor, etc.

• Healthcare Domain
  
  Experience:
  
  8+ years of software engineering experience; 4+ years building healthcare SaaS applications. Strong understanding of Medicare care management programs: CCM, RPM, RTM, PCM, TCM, BHI. Experience implementing CPT code-based billing workflows. Knowledge of CMS reimbursement policies and healthcare revenue cycle management.
• Technical
  
  Skills:
  • Strong experience with C# (NET Core / ASP.NET Core); REST APIs; SQL Server or MySQL.
  • Experience with AI coding tools:
    Augment Code, Cursor, Claude Code, Git Hub Copilot.
  • Experience with Azure or AWS cloud platforms; microservices architecture; event-driven systems; CI/CD pipelines;
    Docker and Kubernetes.
  • Experience with Entity Framework; message queues; distributed systems; integration experience; FHIR APIs; HL7 v2; CCD/C-CDA; EHR integration architecture.
  • Quality & Delivery: unit testing, integration testing, automated testing frameworks, Agile/Scrum, Git-based development workflows.

• Expe…