About the Role
TailorCare is a value-based musculoskeletal (MSK) care platform combining clinical expertise, digital tools, and a yield-based operating model. We are now operationalizing Operating Model 3.0, a shift from uniform delivery to yield-based alignment, in which every patient receives investment proportional to a real-time Yield Score (Probability Value Addressability), and an ROI Gate continuously calibrates Wallet (financial investment) and Muscle (operational intensity).
This requires a data and AI platform that ingests, resolves, scores, decides, and acts in minutes, with the explainability and governance healthcare demands. You will lead that build: set the strategy, design the data platform, drive vendor decisions, and partner with engineering, product, clinical, and operations leadership to deliver it. This is a hybrid strategy-and-architecture role; you will move comfortably from a CTO whiteboard conversation to an EDI 837 parser to a model-evaluation review without losing the thread.
Primary Responsibilities
- Set strategy. Own the multi-year data strategy supporting Operating Model optimization and TailorCares extension beyond MSK; frame tradeoffs for the executive team; protect strategic data moats (canonical patient and provider graphs, proprietary outcome labels, and contribute to yield-calibrated decisioning IP)
- Architect the platform end-to-end. Ingestion, event bus, identity resolution, lakehouse, feature store, ROI Gate decisioning, action orchestration, observability. Define the event taxonomy, schema registry, and data contracts that govern how every source flows in
- Lead vendor strategy. Evaluate and select across clearinghouses, clinical networks, claims systems, provider intelligence, conversational AI, CDPs, and more, negotiating export rights, schema stability, and contribute to defining BAA scope. Build payer-neutral patterns from day one
- Set the bar for HIPAA, PHI, and AI governance. Classification at ingestion, field-level access controls, infrastructure-level scrubbing, vendor data governance, training-data lineage, and consent chains.
- Partner across functions. Translate architecture into staffed delivery with each engineering team; collaborate with clinical leadership on Patient Reported Outcome, extraction accuracy, and outcome labels; work with operations to make the intake and data aggregation meaningful.
- Other duties as assigned
Qualifications
- 10+ years working with healthcare data, including 4+ years in architecture or strategy leadership
- Deep hands-on knowledge of healthcare data: X12 EDI (270/271/276/277/278/834/835/837), FHIR R4, HL7 v2 (especially ADT), CCD/C-CDA, NCPDP, and the realities of integrating with payers, EHRs, clearinghouses, and HIEs
- Experience working with AI team developing predictive models and ability to act as the liaison between AI modeling and data platform.
- Proven track record designing production data platforms at scale, streaming and batch, with managed Kafka or equivalent, lakehouse architectures (Snowflake / Databricks / BigQuery), dbt-style orchestration, modern observability
- Solid grounding in ML/AI systems: feature stores, point-in-time correctness, model lifecycle, NLP for clinical text. You evaluate model proposals on their merits
- Direct experience with patient identity resolution (deterministic + probabilistic) and tokenization (Datavant or equivalent)
- Working knowledge of value-based care economics: MLR, attribution, episode costing, risk adjustment, and how reimbursement models shape data requirements
- Demonstrated executive presence: framing tradeoffs, defending recommendations, adjusting when wrong, staying technically credible
- HIPAA-fluent. You engineer PHI minimization, BAA structures, and audit requirements as first-class concerns
- Ability and willingness to travel up to 10% as needed for onsite meetings, team collaboration, and company events.
Preferred Qualifications
- Hands-on experience with at least one major longitudinal claims dataset (Komodo, Truveta, HealthVerity, Optum, IQVIA) and integration
- Highly collaborative and experienced with a broad range of business holders
- Experience integrating clinical data networks
- Experience with conversational AI in a contact-center context (Cresta, Observe.AI, or built in-house)
- Multi-payer scale experience
- Early-stage / scaling startup background, comfort with ambiguity and the ability to make calls without perfect information
What you will deliver in year one
- Be a key leader in driving build vs. buy data acquisition decisions
- Canonical patient master service in production; 95% deterministic match rate, documented probabilistic strategy
- Real-time event bus with 10 production event types, SLO dashboards, and downstream consumers live
- Real-time ADT, eligibility (270/271) and prior-auth (278) integrations live with sub-second response
- Salesforce (TailorCare-captured) clinical operational data fully instrumented
- Clinical data network integration (Health Gorilla or Particle) with NLP extraction on radiology and specialist notes
- ROI Gate v1 deployed, routing 80% of newly-identified patients; closed-loop attribution from marketing to outcome operational
What's In It For You
- Meaningful Work: We are dedicated to our mission and deeply value our patients and each other. Each day offers the opportunity to make a positive impact.
- Work Environment: We operate as a remote-first company with options for a hybrid work model in Nashville.
- Time Off: Our generous paid time off (PTO) and holiday plans ensure you have ample time to rest and recharge.
- Family First: We offer paid parental leave and support a healthy work-life balance, encouraging flexibility and autonomy. We love talking about our family and pets!
- Comprehensive Benefits: From Day 1, employees enjoy medical, dental, vision, life, and disability insurance, wellness resources and an employer HSA contribution.
- Fair Compensation: We are committed to equitable pay for all team members and support your future goals with a 401k plan that includes employer matching.
- Community: We foster an inclusive environment where you can rely on your teammates, share honest feedback, and feel comfortable being your authentic self at work each day.
TailorCare seeks to recruit and retain staff from diverse backgrounds and encourages qualified candidates to apply. TailorCare is an equal opportunity employer and does not discriminate on the basis of age, sex, gender identity/expression, sexual orientation, color, race, creed, national origin, ancestry, religion, marital status, political belief, physical or mental disability, pregnancy, military, or veteran status.
