Founding Engineer (Potential CTO)

Clera

$170K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 3+ years in mobile/full-stack engineering with a track record of consumer mobile app delivery
  • Proven experience with Claude or other frontier LLMs in production
  • Fluency in React Native with full ownership of the mobile app lifecycle
  • Backend development experience in Node.js or Python with PostgreSQL
  • Experience with HealthKit and wearable APIs, particularly biosignal data
  • Founder mindset with early-stage startup experience

Responsibilities

  • Own direction and execution as the founding engineer and technical leader
  • Ship the v1 AI coaching experience from app development to backend integration
  • Architect and build the nervous system training AI coach
  • Translate biosignals into a real-time personalized coaching layer
  • Build AI-powered QA and testing pipelines
  • Make full-stack decisions across frontend, backend, and AI layers
  • Integrate with iOS/HealthKit and various wearable platforms

Benefits

  • Meaningful early-stage equity with potential for significant value
  • Opportunity to grow into a CTO title as the company scales
  • Work in a fast-paced, innovative startup environment
  • Shape the company's engineering culture and standards
  • Contribute to an AI-native health platform aiming to improve people's well-being.
Full Job Description
About the Role

A fast-moving, seed-stage digital health company is looking for a Founding Engineer (potential CTO) to be the second technical voice on the team. This is a rare 01 opportunity to shape the full engineering direction of an AI-native mobile health platform that uses biosignal data and real-time coaching to help people manage chronic symptoms by improving autonomic nervous system health.

Youll own the architecture, ship the first end-to-end AI product experience, define the engineering culture, and grow into a CTO role as the company scales. This is a deeply hands-on, in-person role based in New York City, San Francisco, or Montreal.
What Youll Do
  • Serve as the founding engineer and de facto technical leader, owning both direction and execution.
  • Ship the v1 AI coaching experience end-to-end - from a React Native mobile app to frontier-model-backed inference and wearable integrations.
  • Architect and build the nervous system training AI coach, including model design, prompt engineering, tool use, and evaluation pipelines.
  • Translate biosignals (HRV, breath, motion, PPG) into a real-time, personalized coaching layer.
  • Build AI-powered QA and testing pipelines to enable safe, rapid daily shipping.
  • Own full-stack decisions across frontend, backend, infrastructure, and AI-native layers.
  • Integrate iOS/HealthKit and wearable platforms (e.g., Apple Watch, Oura, Whoop, EEG headbands).
  • Define and uphold engineering standards and culture as the team grows.
What Were Looking For

Dealbreakers (must-haves):
  • Proven experience shipping and operating Claude or other frontier LLMs in production (prompts, tool use, evals).
  • Ability and willingness to work in-person in New York, San Francisco, or Montreal.
  • 3+ years in mobile/full-stack engineering with demonstrated 01 consumer mobile app delivery to real users.

Required skills & experience:
  • Fluency in React Native with full ownership of the mobile lifecycle (build, release, debug, monitor, iterate).
  • Experience with AI-native infrastructure where AI is integrated across layers, not bolted on.
  • Backend development in Node.js or Python with PostgreSQL and modern infra (Vercel, Fly, Render, or similar).
  • Comfortable moving across frontend, backend, infra, and AI layers with minimal handholding.
  • Experience with HealthKit, wearable APIs, or biosignal data (HRV, PPG, motion) in real-time contexts.
  • Founder mindset with prior first-engineer or early-stage startup experience and the ability to make hard tradeoffs.

Nice to have:
  • Experience building AI-powered testing or evaluation pipelines.
  • Background or deep interest in nervous system science, somatics, neuroscience, or trauma research.
  • Prior experience as the first engineer at a startup.
Compensation & Benefits
  • Base salary: $170,000
  • Equity: Meaningful early-stage equity offered (range up to $2M in potential value)
  • Opportunity to grow into a CTO title as the company scales

Note: Visa sponsorship is not available for this role.
Location

This is an on-site role. Candidates must be able to work in person in one of three locations: New York City, NY  San Francisco, CA  Montreal, Canada. Remote work is not available for this position.

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