Senior ML/LLM Engineer

USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization. SUMMARY US Renal Care is expanding its Clinical Intelligence and Workflow Automation capabilities to support clinicians, reduce administrative burden, and improve patient outcomes. We are seeking a Senior ML/LLM Engineer to design and implement advanced AI systems that power intelligent decision support, workflow automation, and real‑time clinical insights. This role focuses on building agentic AI systems, Retrieval-Augmented Generation (RAG) pipelines, and scalable ML infrastructure that integrates seamlessly with EHR systems, clinical workflows, and operational platforms across the organization. The Team Member will collaborate with clinicians, product leaders, and engineering teams to deliver safe, reliable, and high‑impact AI solutions. Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned. Design and implement AI Agents using frameworks such as LangGraph, Semantic Kernel, or custom orchestration layers. Build and maintain RAG pipelines grounded in clinical guidelines, evidence-based medicine, and real-time patient data. Develop systems that synthesize fragmented clinical data (EHR, labs, imaging, notes) into prioritized insights for clinicians. Architect scalable inference services capable of low-latency performance in clinical environments. Create evaluation frameworks to ensure AI outputs are clinically accurate, unbiased, and aligned with source-of-truth medical records. Implement vector search infrastructure using Pinecone, Milvus, or equivalent technologies. Perform fine‑tuning, PEFT/LoRA training, and model optimization for production workloads. Build high-performance backend services using C#/.NET to integrate AI systems with existing clinical platforms. Ensure all AI systems comply with HIPAA, data privacy requirements, and internal security standards. Research emerging AI technologies and apply them to improve clinician productivity and patient care. Mentor and support other engineers in AI-LLM/ML best practices. Participate in code reviews and contribute to consistent engineering standards. Collaborate with cross-functional teams to translate clinical workflows into automated, intelligent systems. Regular and reliable attendance is required for the job.