Lead Data Scientist

We are seeking a highly experienced Data Science and AI Engineering professional to join our team as a subject matter expert and solution architect. This role will focus on designing, developing, and deploying AI/ML-powered solutions to optimize performance across healthcare and pharmacy-related business processes. The ideal candidate will be a hands-on leader with a strong technical foundation, deep AI expertise, and the ability to drive innovation across cross-functional teams.

• Serve as a subject matter expert and architect, partnering with application development and support teams to design scalable, production-ready AI solutions.
• Design and implement predictive and prescriptive analytics for healthcare use cases such as:
  
  
  
  
  • Drug spend forecasting
  • Insurance plan performance optimization
  • Medication fraud, waste, and abuse detection/prevention
  • Preventive care and personalized treatment planning
  
  
• Fine-tune and adapt large language models (LLMs) to automate and simplify manual healthcare processes, such as:
  
  
  
  
  • Extracting prior authorization rules from clinical guideline documents
  • Validating data exchange files and automating error resolution
  
  
• Collaborate with domain experts to validate model performance and ensure alignment with operational goals.
• Develop and test code across all layers of the AI solution stack to ensure end-to-end system functionality.
• Create and maintain system design documentation.
• Deploy AI models and integrate them into production environments.
• Build and support workflow frameworks for AI model performance monitoring and continuous learning through automated feedback loops.
• Independently initiate and lead end-to-end AI projects, ensuring timely and high-quality delivery.
• Champion the adoption of cutting-edge AI tools and techniques to raise the overall capability and maturity of the data science function.
• Act as a strategic partner to senior leadership, helping prioritize projects and drive data-informed decision-making aligned with organizational objectives.
• Collaborate with cross-functional teams on large-scale strategic initiatives across departments.
• Provide technical mentorship, lead design/code reviews, and promote best practices among junior team members.

• Bachelor's or Master's degree in Computer Science, Engineering, Mathematics, or a related field.
• 10+ years of relevant professional experience or equivalent combination of education and experience.
• 6+ years as a subject matter expert in relevant domains.
• 3+ years of experience in a technical leadership role managing AI or data science teams.
• 2+ years of experience developing AI-driven solutions in pharmacy benefit management or healthcare, including:
  
  
  
  
  • Predictive and prescriptive modeling
  • Fraud, waste, and abuse detection
  • Health plan analytics
  
  
• Familiarity with healthcare data and systems.
• Understanding of prior authorization and pharmacy benefit adjudication workflows.
• Proficiency in SQL and programming languages such as Python or Java.
• Deep expertise in AI/ML/NLP principles, including:
  
  
  
  
  • Generative AI
  • Transformers, LLMs, embeddings
  • Supervised, unsupervised, and reinforcement learning
  
  
• Hands-on experience with tools and frameworks such as:
  
  
  
  
  • PyTorch, TensorFlow, MLP
  • LangChain, HuggingFace
  • AI automation platforms
  
  
• Knowledge of the data science lifecycle, agile development, and best practices for deploying scalable AI systems.
• Strong analytical and problem-solving skills, with a creative and critical thinking mindset.
• Excellent verbal and written communication skills; ability to explain complex technical topics to a broad audience.
• Proven ability to manage multiple concurrent projects with attention to prioritization, scope, budget, and timeline.
• Strong business acumen with the ability to align technical solutions with broader strategic goals.
• Knowledge of market dynamics, competition, and industry best practices.

• Programming Languages:
  
  
  
  
  • Proficiency in Python or Java
  • Strong SQL skills for data querying and manipulation
  
  
• AI/ML & Data Science:
  
  
  
  
  • Deep understanding of AI/ML methodologies including:
    
    
    
    
    • Supervised, unsupervised, and reinforcement learning
    • Natural Language Processing (NLP) and Generative AI
    • Transformers, LLMs, text embeddings
    
    
  • Experience with:
    
    
    
    
    • Predictive and prescriptive analytics
    • Fraud, waste, and abuse detection
    • Forecasting models (e.g., drug spend, health plan performance)
    
    
  • Familiarity with AI model development lifecycle and MLOps
  
  
• Frameworks and Tools:
  
  
  
  
  • PyTorch and/or TensorFlow
  • MLP (Multilayer Perceptrons)
  • LangChain, HuggingFace (for working with LLMs)
  • AI automation platforms
  
  
• Data Engineering:
  
  
  
  
  • Workflow orchestration for model training/monitoring
  • Production deployment and integration of AI systems
  • System design documentation
  
  

Domain Knowledge:

• Experience with healthcare and pharmacy benefit management (PBM)
• Understanding of:
  
  
  
  
  • Prior authorization processes
  • Pharmacy benefit adjudication
  • Healthcare data systems and compliance
  
  

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad Digital, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad Digital offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.


Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.



Qualified applicants in the unincorporated areas of Los Angeles County with criminal histories will be considered for employment in accordance with the Los Angeles County's Fair Chance Ordinance for Employers.



We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.