5+ years of engineering experience with production systems at scale
Expertise in architecting AI-driven systems from the ground up
Strong product-oriented mindset with user-centric thinking
Full-stack proficiency with a focus on back-end technologies
Ownership mentality, capable of driving projects from concept to completion
Ability to balance speed with quality in development processes
Responsibilities
Architect and develop AI-native systems for healthcare
Build reliable AI infrastructure for clinical applications
Set technical direction for scalable patient management
Own features from design to production across platforms
Enhance engineering practices and code quality
Collaborate with patients and providers to inform system design
Benefits
Competitive base salary
Generous equity package
Comprehensive health, dental, and vision insurance
Unlimited dietitian and GLP-1 care
401k with match
Generous PTO
In-office location near Madison Square Park
Citibike and One Medical memberships
Full Job Description
The Role
This is a founding-caliber engineering role. You'll work directly with our founder and leadership team to build the AI-native infrastructure and consumer experiences you've always wished existed in healthcare. You'll be one of a small number of engineers shaping how the system scales from hundreds of thousands of patients in the US to millions across the globe.
We move fast. What you ship today will affect real patients and providers tomorrow. That's the job. AI is at the core of everything we build, both internally and externally. What You'll Work On
Architect and ship AI-native systems from the ground up: autonomous clinical agents, LLM-powered workflows that replace manual processes, intelligent tools that make dietitians dramatically more effective and help us prescribe and monitor GLP-1s at scale
Build the infrastructure that makes AI reliable in a clinical setting: evaluation pipelines, guardrails, feedback loops, the unglamorous stuff that makes the difference between a demo and a product
Set technical direction on our platform, making architectural calls that shape how Berry Street scales from tens of thousands of patients to millions
Own features end-to-end across provider- and patient-facing surfaces, from scoping and architecture through to production
Be a force multiplier for the engineering team: raise the bar on code quality, tooling, and practices without slowing anyone down
Work directly with our patients and providers to deeply understand what they actually need and translate that into systems that hold up at scale
Requirements
5+ years of engineering experience. You've built and maintained production systems at scale. You've made hard architectural calls and lived with the consequences - good and bad.
AI-led, not AI-assisted. We're not looking for someone who uses Cursor / Claude Code / Codex to autocomplete slop faster. We're looking for someone who thinks about how to architect AI-driven architecture from the ground up: autonomous systems that do things that weren't possible two quarters ago. You've shipped something in this space, you have opinions about where it's going, and you're already building for that future.
A product brain. You think about users, not just systems. You push back when a spec doesn't make sense and offer better alternatives. You NEED to understand the 'why'.
Full-stack, back-end leaning. You're comfortable across the stack but strongest on the platform and API side. You know our stack well: React, Next.js, NestJS, TypeORM, PostgreSQL, AWS. TailwindCSS and TypeScript are not intimidating.
An ownership mindset. You take a project from "vague idea" to "shipped and working" without needing someone to hand-hold you through the middle. You flag problems early, drive decisions, and follow through
A bias for speed. You understand the difference between moving fast and cutting corners, and understand when situations call for one or the other.
Our Tech Stack
React & React Native
TypeScript
Next.js / NestJS
TailwindCSS
TypeORM
PostgreSQL
AWS
Benefits
Competitive base salary
Generous equity package
Comprehensive health, dental, and vision insurance
