.NET engineers. Much of the software behind a laboratory, a claim and a hospital was built on the Microsoft stack and is still being extended. .NET engineers build it in C# and ASP.NET Core on SQL Server and Azure, almost always with an Angular screen on top, and the postings often require testing in NUnit, Jasmine and Karma. Eurofins hires most of them for the software its laboratories run on, and Optum India is second. The role is more than twice its weight across the GCCs and at product companies.

GenAI engineers. AI is reading the claim, the approval request and the doctor's note on the healthcare-services side, and the regulated paperwork and the trial data on the drugmakers' side. GenAI engineers build those applications in Python with LangChain, LangGraph and the OpenAI API, on AWS SageMaker and Azure, and many postings also require PyTorch or TensorFlow, semantic search and Responsible AI. Optum India hires the most, followed by Carelon, Bristol Myers Squibb, Amgen, Pfizer and Eli Lilly. The role is nearly twice its weight across the GCCs and well above its weight at product companies, and it is the fastest-growing role here.

Java backend and full-stack engineers. The platforms that process claims and run health plans are built in Java with Spring Boot and React, with Kafka between systems and Spring Batch for the large batch jobs that run overnight. Almost all of this work is at Optum India and Optum, with Carelon and agilon health behind. Java is well below its weight across the GCCs here, because the drugmakers barely hire it.

Cloud and DevOps engineers. Optum India hires most of them, to run UnitedHealth's platforms on Azure, AWS and Google Cloud with Kubernetes and Terraform, with Python and Java for automation. The role holds about its usual GCC weight and takes juniors more readily than most roles here.

Data engineers. A health insurer's business is its claims data, and a drugmaker's is its trial and sales data. Data engineers build the pipelines in Python and SQL with Spark, Airflow, Snowflake and Databricks. Carelon and Optum India hire the most, then Bristol Myers Squibb and Amgen. The role is about twice its weight at product companies, and it takes juniors more readily than most roles here.

Salesforce engineers and the other business platforms. The drugmakers run their sales, their medical teams and their back office on bought platforms. Salesforce engineers build in Apex, Lightning Web Components and Visualforce, deploy with Copado and integrate with MuleSoft. Salesforce is nearly twice its weight across the GCCs and nearly three times its weight at product companies, and Amgen hires most of them. Beside them, enterprise application work, building and connecting business systems in ordinary code rather than on a packaged platform, often in C# and .NET on Azure, is at Optum India and Bristol Myers Squibb. Low-code and automation developers build workflow tools with the Power Platform and Pega at Optum India, Takeda and Eurofins. ServiceNow engineers work at Carelon, Bristol Myers Squibb and Eli Lilly, Workday engineers at Bristol Myers Squibb, SAP engineers at Merck Group, Bristol Myers Squibb and Evernorth, and integration developers on MuleSoft at Amgen.

Software Engineer, Healthtech. Software engineers hired to build for healthcare in particular. Most are ordinary full-stack engineers in JavaScript, TypeScript and Python whose setting is a hospital, a lab or a health plan. A smaller part need healthcare knowledge, and their postings require HL7 and FHIR, the standards health systems use to exchange records, or HIPAA, the American law on keeping patient data private. HCA Healthcare hires the most healthtech software engineers, with Optum India, Eurofins, Carelon and McKesson Compile behind. The role is above its weight across the GCCs.

Python and full-stack engineers. Amgen and Optum India hire Python full-stack engineers who build internal tools and data applications in FastAPI, Flask and Django with React. They are well above their weight across the GCCs. Full-stack engineers working in React and Node on any backend appear at the same two centres and at Eli Lilly.

ML engineers. Model-training engineers work in Python with PyTorch, TensorFlow, Spark and MLflow, for claims and clinical models at Carelon and Optum India, and for drug and trial work at Bristol Myers Squibb and Pfizer. They are nearly twice their weight across the GCCs.

Test engineers. Testing is a small role here, below its weight across the GCCs and at product companies. Takeda hires the most testers for its regulated systems, then Eurofins, Amgen and Carelon. They automate in Java with Selenium, Playwright, REST Assured and Postman.

Frontend engineers. Frontend engineers build the portals of the healthcare-services companies in React, mostly at Optum India. The role is well below its weight, because the .NET and Java full-stack engineers build most screens.

Also present. Power BI analysts at Optum India, Carelon and Eurofins. Mainframe programmers in COBOL, JCL and CICS at Optum India, and on the AS/400 at Accendra Health. Mobile engineers in React Native at Optum India, far below their usual weight. Software Engineer, Security, the software engineers who specialise in security by building login systems, cloud and network protections and the checks that keep code safe, at Optum India in small numbers, far below their usual weight. Generalist software engineers, and a handful of embedded and C/C++ engineers.

Rare here. Chip design and Go backend work do not appear.