Lead Engineer Integrity

Lead Engineer - Payment Integrity

Lead end-to-end engineering for the PISCES HUB initiative. Provide architectural direction and hands-on leadership. Mentor development teams and enforce engineering best practices. Ensure scalability, configurability, and maintainability of rule-driven systems. Collaborate with Product, Payment Integrity SMEs, and Enterprise Architecture teams.

Design and build metadata-driven pipelines and workflow orchestration engines. Dynamic business rule engines for payment integrity use cases. Configurable API/data integration frameworks. Template-based or parameterized services. Develop JSON/YAML/XML-based configuration interpreters. Enable runtime rule updates without redeployment. Design version-controlled rule lifecycle frameworks with auditability.

Design data models for rule storage and versioning. Claims validation configurations. Payment integrity audit trails. Optimize SQL/No

SQL databases for high-volume rule evaluation. Ensure rule governance, auditability, and compliance tracking.

Strong understanding of healthcare payer systems. Claims adjudication workflows. Pre-pay and post-pay validation logic. Payment Integrity rule frameworks. Fraud, Waste & Abuse detection concepts. Experience integrating with core healthcare systems (e.g., Facets, QNXT, Amisys or similar). Ability to translate payment integrity business requirements into scalable technical design.

Design and implement event-driven systems using Kafka. Build microservices deployed in AWS environments: EKS, ECS, Lambda. S3, RDS, DynamoDB. Ensure high scalability and resilience for healthcare transaction workloads.

Implement CI/CD pipelines with automated testing. Containerize services using Docker and Kubernetes. Apply Git Ops workflows for deployment automation. Ensure observability, monitoring, and production readiness.

8+ years of software engineering experience. 3+ years leading engineering teams or owning platform architecture. Strong proficiency in Python or Java (both preferred). Proven experience building configuration-driven systems. Strong database modeling expertise (SQL & No

SQL). Experience designing JSON/YAML/XML configuration interpreters. Hands-on experience with Kafka and event-driven architecture. Experience with AWS cloud services (EKS, ECS, Lambda, S3, RDS, DynamoDB). Strong grasp of CI/CD, Docker, Kubernetes, and Git Ops. Strong knowledge of healthcare systems with focus on Payment Integrity.

Exposure to Machinify platform or similar AI-driven payment integrity systems. Experience integrating rule engines with AI/ML-based fraud detection systems. Experience building healthcare data hubs or enterprise integration platforms. Familiarity with HIPAA-compliant system design.

Strong system design and architectural thinking. Ability to translate healthcare business rules into scalable technical solutions. Ownership mindset with strong accountability. Strong cross-functional collaboration and communication skills. Ability to balance long-term platform vision with delivery timelines.