Senior AI/ML Engineer

About Pedestal Health

Pedestal Health (formerly Target RWE) combines deep health system partnerships, longitudinal data curation at scale, and modern study design to build continuous, high-quality evidence for life sciences organizations.

The company partners with pharmaceutical and biotech companies, providers and payers to generate rigorous, multimodal evidence that supports clinical, regulatory and strategic decision-making across the full lifecycle of care. Pedestal Health is committed to advancing medical decision making to improve outcomes for patients. Pedestal Health is a Highlander Health company. Learn more at pedestalhealth.com.

The Role

Pedestal Health is seeking a Senior AI/ML Engineer to join our Technology team and help shape the next generation of real-world evidence solutions. In this hands-on role, you will design, develop, and deploy scalable machine learning systems — with a particular focus on large language model (LLM) applications.

These systems enable our researchers, statisticians, and clinical teams to extract deeper insights from complex healthcare data. Your work will directly support Pedestal Health's mission of advancing clinical research and informing better healthcare decisions at scale.

This is a highly collaborative position. You will partner closely with software engineers, data scientists, research scientists, and product managers to build high-performing, reliable, and scalable ML-native platforms. You will also serve as a technical leader within the Engineering team, helping cultivate a strong ML engineering culture and staying at the forefront of rapidly evolving AI technologies.

This role reports to the Director of Engineering.

This is a role for someone who thrives at the intersection of cutting-edge AI research and production-grade engineering. The right fit is someone who can translate state-of-the-art methods into durable, enterprise-ready systems while understanding the requirements of clinical research. This is an exceptional opportunity for someone excited about applying AI to transform how clinical evidence is generated and used.

What You'll Do

• Design, develop, and deploy scalable ML software systems to address large-scale analytical challenges in healthcare and real-world evidence generation.
• Translate state-of-the-art LLM research — both internally developed and from the broader research community — into production-ready solutions that deliver measurable value for our customers and internal teams.
• Work with complex, large-scale, real-world clinical data (structured and unstructured) in a cloud-based environment, ensuring quality and reliability across the data pipeline.
• Develop methods and features to ensure high-quality production model results, including drift detection, performance degradation monitoring, and observability tooling.
• Collaborate with software engineers, research scientists, and product teams to build ML-native enterprise platforms, ensuring scalability, efficiency, and reliability at every layer.
• Ensure robust monitoring, logging, and error handling for all deployed ML systems.
• Stay current on the latest advancements in machine learning and AI, and proactively identify opportunities to apply relevant innovations to Pedestal Health's platform.
• Cultivate a strong ML engineering culture across the organization, contributing to best practices, code reviews, documentation, and technical mentorship.
• Partner with cross-functional stakeholders to translate complex technical concepts and model outputs into clear, actionable insights for non-technical audiences.

What You'll Bring

• 5+ years of experience in backend and cloud platform software development, with the flexibility to traverse the stack when necessary.
• Fluency in Python.
• Strong familiarity with modern ML and LLM techniques, frameworks, and tooling.
• Demonstrated experience developing and maintaining high performing, scalable, data-centric enterprise software products.
• Strong problem-solving skills and meticulous attention to detail in technical design, implementation, and documentation.
• Excellent communication skills, with the ability to clearly articulate complex technical concepts to non-technical stakeholders.
• Collaborative team player who thrives in a cross-functional environment alongside engineers, researchers, and product managers.
• Bachelor's degree in Computer Science, Engineering, Mathematics, or a related field, or equivalent practical experience.

Nice to Have

• Experience in 0-to-1 development of end-to-end ML systems, including design, training, inference, deployment, and monitoring.
• Hands-on experience with LLMs in production environments, including fine-tuning, prompt engineering, or retrieval-augmented generation (RAG).
• Experience building the plumbing necessary for RAG-based approaches, including data vectorization, vector stores, and various search methodologies.
• Background in healthcare, clinical informatics, or life sciences, with familiarity with real-world clinical data sources (EHR, claims, registries).

What we offer you

• Hybrid work — 3 days/week in our brand-new office!
• Comprehensive health, dental, and vision for you and your family
• 401(k) with company match
• Generous PTO and company holidays
• Paid parental leave

Hybrid role: Located in Research Triangle Park, North Carolina

If you are ready to be part of a team where your work truly matters—where your expertise is valued, your growth is supported, and your contributions help shape the future of healthcare—Pedestal Health is the place for you. We're building something meaningful together, and we'd love for you to be a part of it.

Pedestal Health is an equal opportunity employer and seeks candidates from diverse backgrounds and abilities.