As Principal Machine Learning Engineer, define and drive the architectural vision for ML and LLM systems that support treatment recommendation, personalization, and intelligent care delivery at scale. Establish foundational design patterns and infrastructure practices that ensure systems are scalable, resilient, secure, and maintainable. Work hands-on with Python and ML frameworks like PyTorch to prototype, optimize, and guide implementation of complex model pipelines and platform components. Partner with platform, product, and clinical teams. Architect and evolve robust ML infrastructure to support continuous training, real-time inference, evaluation, and observability. Lead cross-functional initiatives that simplify system complexity, improve developer velocity, and increase organizational leverage.