Senior Machine Learning Engineer, Multimodal AI

Department: Engineering

Location: San Francisco, CA

Compensation: $170K – $300K • Offers Equity

Employment Type: FullTime

About Hike Medical

Hike Medical is building the defining company in musculoskeletal care. We sit at the intersection of AI, robotics, and healthcare, operating across three product lines: a proprietary AI-vision platform that turns a 30 second web-based foot scan into custom 3D-printed orthotics, an AI agent platform that automates the entire DME workflow from pre-visit processing to claims and revenue cycle, and SoleForge, our vertically integrated 3D printing factory producing custom medical devices at a scale the industry has never seen.

Our customers are both the largest employers on earth and the biggest companies in orthotics and prosthetics. On the clinical side, we're live across the industry's largest national providers. On the employer side, Fortune 50 companies trust us to protect their on-their-feet workforces.

But custom insoles are just the wedge. Our long-term vision is bionics: AI-designed, robotically manufactured orthotic and prosthetic devices at scale, replacing a fragmented, manual industry that hasn't changed in decades. Insoles today, full DME tomorrow, bionics by 2040. Read the full vision at bionics2040.com.

We've stealthily raised $22M through Seed and Series A backed by top-tier investors who invested early in companies like OpenAI, Anduril, and Mercury. We run a fast, results first, high ownership culture out of our new SF Rincon Hill office. If you want to work on problems that sit at the frontier of AI, manufacturing, and healthcare, this is the place.

The Role
As a Senior Machine Learning Engineer, you will build the intelligence layer that automates complex healthcare compliance and document procurement workflows. You will own systems that turn noisy, unstructured inputs such as faxes, phone transcripts, and operational data into reliable structured facts, decisions, and downstream actions.
This is not a pure research role. It is a product and systems role for someone who knows how to turn modern foundation models into dependable production infrastructure. You should be excited by messy real-world data, ambiguous edge cases, and high-leverage workflow automation. You will work across LLMs, OCR pipelines, voice AI, evaluation systems, and backend production infrastructure to help automate the DME process end to end.
What You’ll Work On

• Build and improve multimodal AI pipelines that process healthcare documents, OCR output, transcripts, and workflow context into structured facts and decisions.

• Design LLM-powered extraction, classification, validation, and routing systems for operational and clinical workflows.

• Improve document intelligence systems across OCR, schema extraction, confidence scoring, error handling, and low-quality input recovery.

• Develop voice AI workflows for patient and provider outreach, transcript understanding, post-call extraction, and follow-up automation.

• Create evaluation harnesses, benchmarks, and regression tests for extraction quality, hallucination prevention, workflow accuracy, and model changes.

• Decide when to use LLMs, deterministic logic, retrieval, human review, or hybrid systems to maximize quality and reliability.

• Partner with product and engineering to identify the highest-leverage automation opportunities and translate them into shipped systems.

• Optimize cost, latency, and reliability across model providers and infrastructure layers.

• Work closely with backend engineers to deploy AI systems into our AWS and serverless environment with strong observability and operational rigor.

Technical Requirements

• Strong experience building production AI systems around LLMs, OCR, and unstructured data workflows.

• Proven track record shipping applied AI products, not just prototyping models offline.

• Deep familiarity with modern LLM workflows including prompting, structured outputs, tool use, retries, fallbacks, guardrails, and model evaluation.

• Experience with document intelligence systems such as OCR pipelines, document extraction, classification, post-processing, and confidence-based review flows.

• Experience with voice or conversational AI, or adjacent systems involving transcripts, call automation, and conversational extraction.

• Strong proficiency in Python and comfort working in production codebases with APIs, queues, and backend services.

• Experience deploying and operating AI systems in AWS or similar cloud environments, including serverless or event-driven architectures.

• Strong instincts around evaluation, benchmarking, monitoring, and quality assurance for real-world AI systems.

• Ability to work across structured and unstructured data and design systems that are robust to noisy, incomplete, and ambiguous inputs.

Nice to Have

• Experience in healthcare, claims, revenue cycle, or regulated operational environments.

• Experience with human-in-the-loop workflow design and review tooling.

• Familiarity with telephony vendors, speech systems, or conversational agent infrastructure.

• Experience comparing and routing across model providers such as OpenAI, Anthropic, Bedrock, or equivalent.

• Experience designing internal tools or operational systems used directly by workflow teams.

• Background in machine learning, applied NLP, information extraction, or related fields.