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 the healthcare SaaS application 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.

Are you an AI‑powered software engineer who builds at the speed of thought? If you excel in spec‑driven, AI‑assisted software development using tools such as Augment Code, Cursor, Claude Code, Git Hub Copilot, or similar technologies, we’d love to hear from you.

Beyond strong technical skills, we’re seeking a leader mindset who can champion AI‑driven software development practices, mentor fellow engineers, and help transform the organization’s SDLC through the effective adoption of AI‑enabled engineering tools and workflows. The ability to influence teams, drive change, and foster a culture of continuous innovation is essential.

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)
• 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.

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.

Develop integrations with EHR systems such as:

• Epic Systems
• athenahealth
• AdvancedMD
• eClinical Works
• Next Gen Healthcare

Build interfaces utilizing:

• HL7
• FHIR APIs
• CCD / C‑CDA

Ensure data synchronization, patient matching, and interoperability compliance.

Develop solutions compliant with:

• HIPAA
• CMS requirements
• SOC 2 controls
• HITRUST frameworks

Implement secure coding practices, audit logging, encryption, and access controls.

• Mentor engineers and 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.
• Collaborate with Product and Operations teams to translate regulatory requirements into software capabilities.
• Strong and proven experience in Spec‑Based AI‑Driven SDLC using tools like Claude Code, Augment Code, Cursor, etc.

• 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.
• Strong experience with C#, .NET Core / ASP.NET Core, REST APIs, SQL Server or MySQL.
• 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.
• FHIR APIs, HL7 v2, healthcare interoperability standards, EHR integration architecture.
• Unit testing and integration testing, automated testing…