NLP Engineer CMS Documentation and Intelligent Automation

Key Responsibilities

• Design and build NLP/LLM-driven pipelines to read and interpret CMS manuals, policies, and regulatory guidance.
• Extract rules, conditions, exceptions, and eligibility logic from unstructured and semi-structured CMS documents (PDFs, HTML, Word, policy manuals).
• Implement Document Intelligence / Intelligent Document Processing (IDP) solutions for large-scale CMS content ingestion.
• Convert extracted regulatory logic into machine-readable rules and automated workflows.
• Develop and productionize automation using Python and workflow orchestration tools such as UiPath and Power Automate.
• Collaborate with clinical, compliance, actuarial, and engineering stakeholders to validate rule interpretations and ensure accuracy.
• Ensure outputs are traceable, auditable, and aligned with CMS compliance standards.

Required skills

• Strong experience with NLP and LLM frameworks (e.g., spaCy, Hugging Face, Azure OpenAI/OpenAI).
• Proven hands-on expertise in Python for text processing, rule extraction, and workflow automation.
• Experience with Document Intelligence / IDP platforms and techniques.
• Prioritised practical experience with UiPath, Power Automate, or similar enterprise automation tools.
• Demonstrated ability to process and interpret complex regulatory and policy documents.
• Experience building production-grade AI solutions in regulated industries.
• Requires US residency of 3 years and subject to CMS background Checks.

Desired skills

• Prior experience working with CMS manuals, healthcare regulations, or payer/provider policy documentation.
• Healthcare domain experience (Medicare, Medicaid, RADV, HCC, payment integrity, utilization management).
• Familiarity with agentic AI, rule engines, or decision orchestration frameworks.
• Cloud experience (AWS preferred).