NLP Engineer – CMS Documentation & Intelligent Automation - W2 (Remote)
Position Title NLP Engineer CMS Documentation & Intelligent Automation - W2 (Remote) Position Overview We are seeking an NLP Engineer with strong automation expertise to design and implement intelligent solutions that can read, interpret, and operationalize CMS manuals and regulatory guidance. This role focuses on leveraging NLP and LLM technologies to extract rules, conditions, exceptions, and compliance logic from complex structured and unstructured healthcare documentation and automate downstream workflows using Python and enterprise automation tools.
Key Responsibilities
Design and develop NLP/LLM-driven pipelines to process CMS manuals, policies, and regulatory documentation.
- Extract structured information such as rules, conditions, exceptions, and eligibility logic from unstructured and semi-structured content (PDFs, HTML, Word documents, policy manuals).
- Implement Document Intelligence / Intelligent Document Processing (IDP) solutions for large-scale healthcare documentation ingestion.
- Convert extracted regulatory and policy logic into machine-readable rules and automated workflows.
- Develop and productionize automation workflows using Python and orchestration tools such as UiPath and Power Automate.
- Collaborate with clinical, compliance, actuarial, and engineering teams to validate interpretations and ensure accuracy.
- Ensure all outputs are traceable, auditable, and compliant with regulatory standards. Required Skills & Experience
- Strong experience with NLP and LLM frameworks (e.g., spaCy, Hugging Face, Azure OpenAI / OpenAI).
- Hands-on expertise in Python for text processing, rule extraction, and automation development.
- Experience with Document Intelligence / IDP tools and techniques.
- Practical experience with UiPath, Power Automate, or similar enterprise automation platforms.
- Proven ability to process and interpret complex regulatory and policy documentation.
- Experience building production-grade AI/ML solutions in regulated environments.
- Minimum 3 years of U.S.-based work experience (required).
- Must be eligible to pass CMS background checks. Preferred / Desired Skills
- Experience working with CMS manuals or healthcare regulatory documentation.
- Domain knowledge in Medicare, Medicaid, RADV, HCC, payment integrity, or utilization management.
- Familiarity with agentic AI, rule engines, or decision orchestration frameworks.
- Cloud experience, preferably AWS.
- Prior experience in payer/provider healthcare environments. Additional Information
- Any work authorization is acceptable.
- Remote role.
- Candidates with prior experience in large healthcare or enterprise organizations are preferred.