Senior Software Engineer (AI / Full-Stack)

Lawrence Harvey

$150K — $180K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 4+ years of professional software engineering experience or equivalent seniority
  • Strong experience in Python, especially for backend or AI systems
  • Proficient in TypeScript/React for building modern product experiences
  • Hands-on experience with LLM-powered applications in production
  • Familiarity with realtime communications technologies like WebRTC and SIP
  • Strong engineering focus on reliability, security, and observability
  • Excellent communication skills for collaboration with product and non-technical stakeholders

Responsibilities

  • Build and deploy features for both the core healthcare product and voice AI platform
  • Develop production-grade voice agents for patient communications
  • Enhance realtime systems including transcription and call routing
  • Design workflows and agent behavior powered by LLMs
  • Create evaluation frameworks and perform regression testing for AI systems
  • Debug and strengthen the reliability of AI in production
  • Manage production aspects like latency and safe deployments

Benefits

  • Work on innovative AI solutions already implemented in healthcare
  • Tackle technical challenges in voice AI and realtime systems
  • Contribute to significant areas of both frontend and backend
  • Direct interaction with senior engineering and product leadership
  • Influence product development within a small team
  • Shape the deployment of AI in patient-facing healthcare workflows
Full Job Description
  • Senior Software Engineer, AI / Full-Stack
  • Location: San Francisco, United States (Hybrid)
  • Type: Full-time
  • Work Auth: Must be a US Citizen/Green Card Holder

The Opportunity

We're looking for a Senior Software Engineer with strong AI / Full-Stack experience to play a key role across both the core product and next-generation AI capabilities.

A major focus of the role will be building and improving production voice AI systems including AI agents that communicate with patients and care teams, realtime transcription, multilingual experiences, intelligent escalation, and the workflows that enable reliable conversations.

Alongside the AI work, you'll contribute heavily to the customer-facing product, building sophisticated workflows, dashboards, and services used by healthcare organizations.

This is an opportunity for an engineer who enjoys working across the stack and wants to take AI systems beyond prototypes into reliable, production-grade products.

What You'll Do
  • Build and ship features across the core healthcare product and voice AI platform.
  • Develop and improve production voice agents for outbound and inbound patient communication.
  • Work on realtime systems including transcription, turn-taking, tool use, call routing, and human handoff.
  • Design and improve LLM-powered workflows, prompts, tools, and agent behavior.
  • Develop evaluation frameworks and regression testing for AI systems.
  • Debug and improve the reliability of nondeterministic AI systems in production.
  • Own production considerations including latency, observability, safe deployments, and failure recovery.
  • Build modern customer-facing experiences using React and TypeScript.
  • Develop backend services and APIs using Python and related technologies.
  • Work closely with product and clinical stakeholders to determine how AI should be used safely and effectively.
  • Contribute across adjacent product, backend, and integration work as the needs of a small team evolve.

What We're Looking For
  • 4+ years of professional software engineering experience or equivalent seniority.
  • Strong Python engineering experience, particularly across backend or AI/agent systems.
  • Strong TypeScript/React experience and the ability to build modern product experiences.
  • Hands-on experience building LLM-powered applications in production.
  • Experience with tool/function calling, prompt and workflow design, LLM evaluation, and production debugging.
  • Experience with realtime communications, telephony, streaming audio, WebRTC, SIP, or similar technologies is highly desirable.
  • A strong engineering mindset around reliability, security, observability, and production quality.
  • Comfort working in a small, fast-moving environment with significant autonomy and ambiguity.
  • Strong communication skills and the ability to work closely with product and non-technical stakeholders.

Nice to Have
  • Experience with voice AI or agent frameworks such as LiveKit Agents.
  • Experience with healthcare technology, HIPAA, or SOC 2.
  • Experience with AWS/serverless architectures.
  • GraphQL experience.
  • Experience building complex workflow or analytics-driven UIs.
  • Experience developing automated evaluations or scenario-based testing for AI agents.

Technology

Python • LiveKit • LLMs • SIP/Telephony • React • TypeScript • AWS • GraphQL • pytest

Why This Role?
  • Build AI products that are already being used in real-world healthcare environments.
  • Work on technically challenging voice AI and realtime systems, rather than simple LLM wrappers.
  • Own meaningful parts of the product across both frontend and backend.
  • Work directly with senior engineering and product leadership.
  • Join a small team where your technical decisions have a direct impact on the product.
  • Help shape how AI is safely deployed in patient-facing healthcare workflows.

If this Senior Software Engineer role sounds like you, then please apply today!

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