Founding Engineer

Terrarium

$120K — $180K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of experience in software engineering, with a focus on system architecture.
  • Experience building and launching products or platforms from the ground up.
  • Strong proficiency in data systems and ingestion pipelines.
  • Familiarity with AI and machine learning technologies for analytics.
  • Ability to operate in chaotic environments with minimal oversight.
  • Excellent problem-solving skills and a first-principles mindset.

Responsibilities

  • Design and build the core platform's technical architecture.
  • Develop data ingestion pipelines for healthcare data integration.
  • Implement AI algorithms for continuous system analysis and risk detection.
  • Create agentic systems for coordinating healthcare logistics and scheduling.
  • Ensure compliance and documentation for all actions within the platform.
  • Make decisive architectural choices to enhance platform performance.
  • Lead technical decisions and maintain end-to-end ownership of solutions.

Benefits

  • Flexible work environment that fosters autonomy.
  • Opportunity for significant impact in healthcare innovation.
  • Startup culture with high responsibility and ownership.
  • First access to fresh technology and methodologies.
  • Collaboration with passionate individuals dedicated to meaningful problems.
Full Job Description
About the role

As the Founding Engineer, you are our first engineer and the technical leader. You will build the core platform from scratch, owning architecture, data systems, ingestion pipelines, the intelligence layer, and the initial agentic systems that turn a complete record of a senior's health and life into coordinated action.

We operate through four layers:
  • Ingest & Store: Pull and structure data from across the healthcare system and combine it with real context on family, caretakers, medications, appointments, and daily life. The goal is one clean, reliable record instead of scattered fragments.
  • Intelligence: Use AI to continuously analyze the full picture, detect gaps and risks, and prioritize what actually matters.
  • Action: Build agents that execute real coordination work (scheduling, logistics, reconciliation, documentation) while keeping the human navigator in the loop with full visibility.
  • Compliance: Make sure every action is properly documented and auditable so the system can scale responsibly.

Expect to make high-leverage technical decisions, ship fast, and own outcomes end-to-end with minimal process. This is a true 0-1 role. You will define how the platform works.

Who we're looking for
  • You have built real systems from scratch and take extreme ownership of problems end-to-end.
  • High agency. You figure things out, move fast, and do whatever it takes to make progress. You don't wait for perfect requirements or perfect conditions.
  • You thrive in ambiguity and chaos. You prefer clear goals and maximum freedom over hand-holding and process.
  • You are genuinely excited to work on hard problems that matter. Fixing broken parts of healthcare for the people who need it most is meaningful to you.
  • First-principles thinker with strong technical judgment. You make pragmatic architecture decisions and ship high-quality work quickly.
  • Low ego, high output. You want the intensity and ownership that only exists at the earliest stage of a company.

If you need constant direction, clear roadmaps, or a well-defined role, this is not the right place.

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