PHI Senior AI Engineer

Prudentials purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured for our people customers and partners. We provide a platform for our people to do their best work and make an impact to the business and we support our peoples career ambitions. We pledge to make Prudential a place where you can Connect Grow and Succeed.

Prudential (UK) in partnership with the HCL group plans to set-up a standalone Indian health insurance company to address the growing healthcare needs of the Indian consumer.

This joint venture will combine Prudentials global expertise in insurance and financial services with HCL Groups experience in technology and healthcare solutions.

Prudential with its longstanding presence in India already operates two leading businesses in life insurance and asset management with the ICICI Group. Prudential was also the proud sponsor of the 1983 Cricket World Cup Indias first World Cup Victory!

Prudential Health India is a Zero to One team undertaking a no-legacy greenfield health insurance deployment in India building journeys that truly empathize with the customer and offer a differentiated experience.

To partner with us in this mission we are looking for a talented Senior AI Engineer to join our Technology in Mumbai.

Location: Mumbai (100% Onsite)
Reporting to: Enterprise Architect

Mission

Architect the companys proprietary SaaSKiller Agentic AI Stackthe intellectual backbone that will replace external platforms and secure our long-term technology sovereignty.

1. The Total Replacement Roadmap

I. Agentic Claims Adjudication (SaaS Replacement)

Objective: Build an in-house AI-native Claims Management System to replace thirdparty CMS platforms.
Execution:

• Design backend pipelines to ingest and validate medical data via NHCX.

• Automate clinical scrutiny and rule-based adjudication using agentic workflows.
  Outcome:

• Straight-Through Processing (STP) with near-zero manual intervention.

• Decommissioning of legacy SaaS workbenches.

II. Predictive FWA & Real-Time Risk Sovereignty

Objective: Replace external Fraud Waste & Abuse (FWA) platforms with an in-house predictive risk engine.
Execution:

• Build scoring models for every pre-auth and claim using proprietary fraud signatures.

• Develop a real-time risk brain that analyzes patterns at the point of care.
  Outcome:

• A live Provider Trust Score that auto-triggers approvals or investigations.

• Zero dependency on third-party FWA suites

III. Autonomous Provider Network & Portal

Objective: Build a proprietary Network Control Tower as a replacement for external hospital portals and network tools.
Execution:

• Architect secure bidirectional data interoperability using HL7 FHIR and ABDM standards.

• Enable automated onboarding tariff updates and network insights.
  Outcome:

• Dynamic package pricing automated negotiations and self-updating network datapowered by agentic backends.

2. Requirements & Qualifications

Core Engineering (Must Have)

• 6 years of experience in high-scale backend engineering using Python Go or Java.

• Proven ability to build robust scalable distributed systems.

The Builder DNA (Must Have)

• Demonstrated history of building systems from scratchnot just configuring SaaS tools.

• Comfort owning architecture end-to-end with minimal external dependencies.

AI/ML (Preferred)

• Experience deploying AI models or ML-backed workflows is beneficial.

• Strong mathematical and logical grounding to quickly adopt:

  • Vertex AI

  • Gemini models

  • Agentic frameworks (LangGraph CrewAI)

GCP Readiness

• Willingness to become proficient with:

  • Vertex AI

  • BigQuery ML

  • Document AI

  • Cloud-native microservices & orchestration

Interoperability Enthusiasm

• Interest in mastering the evolving healthcare standards:

• National Health Claims Exchange (NHCX)

  • ABDM protocols

  • FHIR-based data flows

3. Why This Role

Technology Sovereignty

You will lead the build-out of platforms that replace multi-crore SaaS tools and define the companys technological autonomy.

Deep IP Ownership

Every module built reduces reliance on third-party vendors and directly increases company valuation.

Direct Leadership Access

Work hands-on with the CTIO and business heads at the Mumbai HQ.

Candidate Profile

The ideal candidate is a senior backend engineer who:

• Wants to transition into Agentic AI leadership.

• Believes the UPI moment for insurance (NHCX) demands a fully custom AI-native architecture.

• Has a strong bias for first-principles design and building proprietary systems over vendor customization.

The initial technical interview will focus on:

• Your most complex build-from-scratch backend project.

• Youre thinking around architectural sovereignty and system ownership.

Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex race age ethnic origin educational social and cultural background marital status pregnancy and maternity religion or belief disability or part-time / fixed-term work or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.