Lead Clinical Automation & AI Systems Engineer
Department: Clinical Operations & Technology Engineering
Reports to: Founders & Associate Director of Clinical Operations
Location: Midtown Manhattan, NYC (Hybrid preferred; Remote considered for exceptional candidates)
Salary: 150-200k yearly
What You'll Build & Own
Autonomous & Assistive Clinical Agents: Design, test, and deploy multi-agent systems that autonomously execute multi-step operational tasks (e.g., insurance verification, medication schedule reconciliation, lab result triaging, and patient-tailored educational updates).
Stateful Workflow Orchestration: Build resilient, state-driven workflow pipelines (using modern orchestration platforms like Temporal, Inngest, or LangGraph) that safely bridge probabilistic LLM outputs with deterministic clinical operations.
Human-in-the-Loop (HITL) Architectures: Architect internal tooling and queues that allow physicians, embryologists, and patient coordinators to supervise, inspect, and approve AI-generated actions before they write back to production systems.
EHR & Systems Interoperability: Build reliable API-level integrations connecting our core Electronic Health Record (EHR) / IVF Practice Management Systems (eIVF) with our communications stack, billing engines, and laboratory data layers.
Reliability, Evals & Guardrails: Implement programmatic validation layers (e.g., Pydantic, Instructor), safety guardrails, and automated evaluation suites to continuously measure model latency, hallucination rate, token cost, and clinical accuracy.
Operational Discovery & Technical Roadmapping: Embed with clinical coordinators, billing specialists, and fertility doctors to reverse-engineer messy, manual workflows and convert them into clean, high-scale software systems.
What You Bring
Core Software & Engineering Foundations:
3-5+ years of professional software development experience (proficient in Python and/or modern TypeScript).
Solid understanding of API architecture (REST, webhooks, GraphQL), event-driven systems, and modern relational databases (PostgreSQL/SQL).
Healthcare workflows & PHI: Demonstrated knowledge of healthcare workflows and safeguards for protected health information (PHI), including HIPAA/HITECH requirements, is required. Hands-on professional experience working in a healthcare setting and handling PHI is also required.
Applied AI & Automation Tooling:
Agentic Frameworks: Hands-on experience building with modern LLM orchestration frameworks (LangGraph, LlamaIndex, CrewAI, AutoGen) and stateful workflow engines (Temporal, Inngest, or AWS Step Functions).
Deterministic AI Engineering: Deep knowledge of tool-calling / function-calling, structured data extraction (Pydantic, Instructor, Outlines), and Retrieval-Augmented Generation (RAG) over clinical or operational SOPs.
Model Monitoring & Evaluation: Familiarity with tracing, evals, and observability tools (e.g., Langfuse, LangSmith, Arize Phoenix, DeepEval).
Mindset & Problem Solving:
Pragmatism Over Hype: You recognize when a problem calls for an autonomous agent vs. a fast deterministic Python script vs. a vendor SaaS tool. You optimize for uptime, clinical safety, and user adoption.
Cross-Functional Fluency: You can speak technical details with software vendors in the morning, and sit elbow-to-elbow with a clinical coordinator or fertility physician in the afternoon to map their workflow.
Product Ownership: Comfortable operating in a fast-paced environment where you own the full lifecycle from problem discovery through implementation, unit testing, user training, and maintenance.
Nice-to-Haves
Healthcare interoperability: Experience with healthcare standards and APIs such as FHIR, HL7, or SMART on FHIR is a plus.
Direct domain experience in fertility care, reproductive endocrinology, ambulatory care, or health-tech startups.
Experience building custom internal front-ends (Retool, Streamlit, React, or Next.js) for internal human-review interfaces.
Track record of successfully replacing legacy RPA (UiPath, Power Automate) with clean, maintainable code-based microservices.
Comprehensive Benefits: Competitive salary, bonus, health insurance, 401(k) matching, and work flexibility.
