PHI - Senior AI Engineer

Prudential’s 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 people’s 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 Prudential's global expertise in insurance and financial services with HCL Group’s 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, India’s 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% On‑site) Reporting to: Enterprise Architect Mission Architect the company’s proprietary “SaaS‑Killer” Agentic AI Stack —the 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 third‑party 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 data—powered 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 scratch —not 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 company’s 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 . You're 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.