This book provides a comprehensive guide to applying AI/ML in healthcare insurance, from understanding raw claims data to deploying risk models in production environments. It presents a data-to-decision journey—integrating scalable engineering, ethical AI practices, and predictive modeling in the healthcare insurance lifecycle. With insights from real-world U.S.-based Health tech projects, it empowers readers to design, implement, and interpret machine learning pipelines tailored for risk scoring, fraud detection, and care optimization. It covers such tools as Apache Spark, Azure, and Databricks.

Rakesh Ramakrishna Pai is a Data Engineering Leader with more than 15 years of experience building large-scale cloud, AI, and analytics platforms across healthcare and enterprise domains. Holding an MBA in Business Analytics from the University of Hartford, he specializes in AWS, Azure, Databricks, Spark, Python, and Kubernetes and has deep expertise in Lakehouse architecture, real-time pipelines, and HIPAA-compliant data ecosystems for ML/AI workloads.

Rakesh leads enterprise Databricks Lakehouse platforms powering more than 200 pipelines and real-time analytics across healthcare insurance systems, processing more than 10TB daily of healthcare data. He has delivered multi-terabyte scalable systems, modernized legacy platforms with 5×+ performance improvements, and driven measurable business impact across clinical and operational programs.

Dr. Bishwajeet Pandey is a Professor at GL Bajaj Institute of Technology and Management, Greater Noida, India, and a Visiting Professor at UCSI University, Malaysia. He has been a Senior Member of IEEE since 2019. Dr. Pandey holds an MTech in Computer Science from IIIT Gwalior, India, and a PhD in Computer Science from the Gran Sasso Science Institute, Italy.

He has previously taught at several esteemed institutions, including Chitkara University, Jain University, Astana IT University, Eurasian National University, and Walsh College. A prolific researcher, Dr. Pandey has authored more than 30 books and published more than 220 Scopus-indexed research papers, accumulating more than 4,600 citations.

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