We are seeking a IT Systems Administrator to own the day-to-day health, security, and performance of our cloud infrastructure and end-user environment. This is a hands-on role for someone comfortable operating across Microsoft 365 / Azure, identity and endpoint security tooling, and a virtualized desktop environment, while also managing the relationship with our outsourced service-desk partner to make sure tickets move, SLAs are met, and our clinical staff get fast, reliable support. You'll be equally comfortable heads-down in the Azure/Entra portal and on a call pushing a vendor for a real answer. Understanding and appropriate use of AI-enabled tools (Copilot, Claude, and similar) is part of how this team works, mainly for scripting, documentation, and routine automation.
Work Schedule: M-F 8a-5p
Location: 4383 Medical Dr. San Antonio, Texas 78229
Essential Responsibilities:
- Administer Microsoft 365 (Exchange Online, SharePoint, Teams, OneDrive), including provisioning, licensing, groups, and permissions.
- Manage Azure/Entra ID: users, groups, conditional access, and identity governance.
- Configure and maintain SSO/MFA and enforce least-privilege access.
- Own Azure-based backup and disaster recovery, including regular restore validation.
- Monitor endpoint security CrowdStrike and drive patch compliance (Qualys).
- Support Citrix-delivered virtual desktops used to access clinical/research applications.
- Manage new-hire and offboarding lifecycle in Entra ID and M365 licensing.
- Act as the internal escalation point for our outsourced help desk, tracking SLA performance.
- Maintain clear documentation: runbooks, access policies, and standard procedures.
- Deliver Day-1 IT readiness for new clinic openings (network, endpoints, telephony, identity, and system access), working from the site-buildout playbook.
- Manage endpoint provisioning at scale with Intune / Autopilot across US and EU sites.
- Support security incident response with the Cyber Security team, providing endpoint remediation and investigation support alongside our monitoring partners.
- Troubleshoot site-level network issues (LAN, Wi-Fi, firewall) and coordinate infrastructure changes with our network/cloud vendor partners.
- Apply AI-enabled tools where appropriate to accelerate scripting, documentation, and routine automation.
Required Education and Experience:
- 3+ years administering Microsoft 365 and Azure/Entra ID in a production environment.
- Hands-on experience with conditional access, MFA/SSO, and identity governance.
- Familiarity with endpoint security (EDR) and patch/vulnerability management.
- Comfortable troubleshooting across a fully cloud-based stack (no on-prem AD or Exchange).
- Strong written communication; able to document clearly and manage vendor accountability.
- Comfortable adopting AI-enabled tools such as Copilot or Claude for scripting, troubleshooting, and documentation.
- Willingness to participate in an after-hours escalation rotation for P1 incidents (we operate 24x7 with a Tier 1 partner in front of you).
- Ability to travel to new clinic sites for IT buildouts (estimated 10-20%, concentrated around site openings).
Preferred Education and Experience:
- Microsoft Certified: Azure Administrator Associate or Microsoft 365 Certified.
- Experience in healthcare or another regulated (HIPAA) environment.
- PowerShell / Microsoft Graph API scripting for provisioning and reporting.
- Experience with Citrix VDI and multi-site/international support.
- Interest or experience in AI-driven automation (ticket triage assistance, runbook generation, incident summaries).
Best-in-Class Benefits and Perks
We value the time, talent, and dedication our employees bring to START. Our commitment to your well-being and growth is reflected in a competitive compensation package-based on experience-along with comprehensive benefits designed to support you both personally and professionally:
- 401(k) retirement savings plan with employer match
- Eligibility for an annual performance bonus, based on role and company results
- Generous paid time off and paid holidays
- Comprehensive medical, dental, and vision coverage and optional insurance options
- Company paid life and disability insurance for added financial protection
- Employee Assistance Program (EAP) providing confidential, no -cost support for you and your family from day one
- Flexible FSA and HSA plans to support your financial wellness
- Commitment to a supportive environment that values balance, wellbeing, and flexibility
- We're committed to fostering a collaborative, creative workplace where every team member is encouraged to contribute. At START, you'll join a team that values continuous learning, professional growth, shared ideas, and a culture built on inclusivity and innovation.
