Founding Full Stack Engineer

Clera

$135K — $155K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of experience building and delivering production SaaS products
  • Proficient in TypeScript, React, and Node.js
  • Expertise in backend design for multi-tenant, workflow-driven applications
  • Experience with enterprise authentication systems (SSO/SAML) and integrations (RBAC, audit logging, HRIS)
  • History of taking ownership in an early-stage startup environment
  • Skilled in defining CI/CD pipelines and architectural standards
  • Strong communication skills for collaboration with non-technical stakeholders

Responsibilities

  • Own architecture and implementation across four product areas
  • Design data models for complex healthcare organization structures
  • Build AI-assisted document workflows and evidence retrieval systems
  • Implement an enterprise-grade infrastructure including user authentication and auditing
  • Translate customer feedback into shipped product features
  • Define and manage CI/CD pipelines and testing strategies
  • Collaborate with product experts to align engineering work with operational needs

Benefits

  • Early-stage equity for founding engineering contributions
  • Opportunity to shape the company's technical direction
  • Engage in innovative projects affecting large healthcare systems
Full Job Description
About the Role

We're an early-stage healthtech SaaS company building a unified platform that helps large healthcare organizations - including complex, multi-hospital systems - measure, manage, and prove the ROI of their nursing excellence programs. Think professional governance, clinical ladder programs, evidence-based practice, and designation readiness, all in one enterprise-grade product.

As a Founding Full Stack Engineer, you'll own architecture and implementation across multiple integrated products. You'll design the core infrastructure, data models, and AI-driven workflows that translate customer insights directly into shipped features - and you'll help set the engineering standards that allow us to scale securely across enterprise healthcare customers.

This is a senior, hands-on founding role with significant scope and ownership. You won't just build features - you'll shape how we build everything.
What You'll Do
  • Own architecture and implementation across four integrated product areas.
  • Design data models that support complex multi-hospital and multi-unit organizational structures.
  • Build AI-assisted workflows for document authoring, evidence organization, and retrieval.
  • Implement enterprise-grade infrastructure including SSO/SAML, RBAC, audit logging, and HRIS integrations.
  • Translate customer conversations and domain knowledge into concrete, shipped product features.
  • Define and own CI/CD pipelines, testing strategies, and architectural standards for a growing engineering team.
  • Collaborate closely with product and non-technical stakeholders to align engineering work with clinical and operational needs.
What We're Looking For

Must-haves:
  • 5+ years building and delivering production SaaS products with end-to-end ownership.
  • Strong full-stack proficiency with TypeScript, React, and Node.js in production environments.
  • Proven backend design experience for multi-tenant, workflow-heavy applications.
  • Hands-on experience implementing enterprise auth systems (SSO/SAML) and integrations such as RBAC, audit logging, and HRIS.
  • Demonstrated ability to own architecture and execution in an early-stage startup environment.
  • Experience defining CI/CD pipelines, testing strategies, and architectural standards for growing teams.
  • Strong communicator - comfortable working directly with non-technical domain experts and enterprise customers.

Nice-to-haves:
  • Hands-on experience with AI-assisted workflows for writing, evidence organization, or document retrieval.
  • Familiarity with Next.js, PostgreSQL, Supabase, Vercel, or AWS S3.
  • Experience with data modeling for multi-hospital or multi-unit organizational structures.
  • Background in healthcare, clinical workflows, or regulated industries.

Note: Visa sponsorship is not available for this role. Candidates must be authorized to work in the United States.
Compensation & Benefits
  • Salary: $135,000 - $155,000 per year
  • Early-stage equity commensurate with a founding engineering role
  • Opportunity to shape the technical direction of a company from the ground up
Location

This role is based on-site in San Francisco, CA. Candidates should be local or willing to relocate.

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