The Role:

Ambience ships clinical AI to millions of patient encounters across the nation's largest health systems. How fast we improve that AI depends on the platform you'll own.

You'll build evaluation and release gates that let teams ship confidently. Observability that surfaces quality issues before clinicians do. Debug tooling that makes reproducing regressions fast. The chart context retrieval layer that assembles patient history into model-ready inputs.

The goal: teams iterate on quality in days, not weeks. Every improvement you make compounds across every product team, every quarter.
Our engineering roles are hybrid in our SF office (3x/week).

What You'll Own:

• Eval & Release Infrastructure - Automated graders and release gates that work across product pods. Unified eval dataset versioning and execution to replace fragmented workflows. Production quality monitoring with end-to-end tracing, shared metrics, and automated alerting.
• Debug Tooling - Encounter replay that reconstructs exact inference inputs (retrieved chart context, packed prompts, model versions) so teams reproduce issues without digging through logs. Diff views comparing known-good runs to regressions.
• Chart Context & Data Pipelines - The retrieval layer that pulls relevant patient history and assembles it into consistent model-ready inputs. Feedback loops that capture real-world usage and convert it into training signal. End-to-end latency instrumentation across every workflow step.
• Preference Infrastructure - The system that enables clinician and site-specific behavior across specialties. Different clinics want different defaults, different phrasing, different workflows. You'll build the platform that supports customization at scale.
• Model Serving - Performance and reliability layer for critical in-house models with clear SLOs, capacity planning, and regression alerts.

Who You Are:

• 7+ years in software engineering, 3+ focused on ML infrastructure, platform engineering, or data systems
• Staff-level scope: owned cross-cutting infrastructure, influenced technical direction across multiple teams
• Strong backend fundamentals in Python, TypeScript, or similar
• Built eval systems, data pipelines, or ML observability infrastructure
• Comfortable on both the ML and Eng sides of MLOps
• Track record of platform work that measurably accelerated other teams
• In SF, 3x/week in-person

Why Here:

Healthcare data is messy, customer-specific, and high-stakes. FHIR resources mutate in undocumented ways. Every health system has different mappings. Context windows hit 100K tokens. You're figuring out how to give models the right context for millions of patient encounters across dozens of specialties.

Small team, high trust, direct access to leadership. Staff engineers here shape technical direction, not just execute on it.

Pay Transparency
We offer a base compensation range of approximately $250,000-300,000 per year, exclusive of equity. This intentionally broad range provides flexibility for candidates to tailor their cash and equity mix based on individual preferences. Our compensation philosophy prioritizes meaningful equity grants, enabling team members to share directly in the impact they help create.

Are you outside of the range? We encourage you to still apply: we take an individualized approach to ensure that compensation accounts for all of the life factors that matter for each candidate.

Life at Ambience

Working at Ambience means opting into a high-ownership, high-trust environment built for people who want to grow fast, operate decisively and focus on work that matters. This could be the right place for you if you want to

• Work on mission-critical AI technology that directly improves clinicians' day-to-day lives and health system financial health across some of the most complex, high-stakes workflows in the world.
• Join a "dream team" culture where we hire exceptional people, expect exceptional outcomes and invest deeply in feedback and continuous growth. We operate as a championship team, and that means being ok with hard, uncomfortable, ambiguous problems that lead to real greatness.
• Operate with real ownership and accountability in an environment where there are no bystanders: If something is broken, we fix it! You will have meaningful autonomy and be expected to drive work to completion.

To help you do your best work, we pair these expectations with benefits intentionally designed to help you feel supported and safe at Ambience and beyond. Some of our key benefits include

• Comprehensive medical, dental, and vision coverage for you and your dependents
• 401(k) with a company match of up to 3% of base salary
• A remote-friendly culture (with a San Francisco HQ) and full equipment provisioning to ensure you can work effectively from wherever you're based.
• Parental leave to support your family needs
• Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings, with travel, lodging and meals covered
• Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24-January 1 designed to support real rest and long-term sustainability.