The opportunity: We're small, shipping fast, and tackling high-impact problems at the intersection of AI, healthcare data, and reliability. You'll bring deep technical judgment and help set the engineering bar for a young, high-ownership team.
What you'll do- Own critical systems end-to-end: From design to production-across our AI-powered intake, referral, and document automation pipelines.
- Architect for scale & correctness in a regulated environment: resilient workflows, idempotent jobs, auditability, and strong observability.
- Ship AI features responsibly: integrate and evaluate LLMs (prompting, retrieval, eval harnesses, safety guardrails), optimize performance, and measure real-world impact.
- Integrate with EHRs/EMRs and third-party systems; design stable APIs and event-driven services that keep patient charts in sync.
- Raise the bar-mentor engineers, lead design reviews, improve our SDLC, and champion reliability.
- Partner with product & customers to turn ambiguous workflows into clean, scalable automation.
What success looks like (30/60/90)- 30 days: You've shipped a production change in a core service, authored a concise design doc, and stood up dashboards for your area.
- 60 days: You own a system boundary and its SLOs; you've reduced a costly failure mode or shaved minutes off a common workflow.
- 90 days: You've led a cross-team project (e.g., a new agent deployed or new EHR connector) that measurably reduces manual touches and boosts provider throughput.
What we're looking for- Senior scope: 7+ years building production systems (or equivalent impact) and a track record of leading complex projects across teams.
- Strong backend fundamentals: service design, data modeling, transactions, background processing, performance profiling, observability.
- AI in production: experience integrating models, prompt/RAG patterns, evaluation frameworks, and safety/guardrails.
- Pragmatic builder: you write crisp design docs, slice scope intelligently, and iterate with tight feedback loops.
- Excellent communicator & mentor who uplevels others and brings clarity in ambiguous domains.
- Security & privacy mindset (bonus if you've worked with PHI or in regulated environments).
Nice to have- Ruby on Rails or Python at scale; polyglot comfort (we use Python, Ruby, JavaScript, Go).
- GCP & Kubernetes, and modern observability (OpenTelemetry).
- SQL depth (MySQL) and data pipeline experience.
- Early-stage startup experience (01 and 11).
What We Offer:- Competitive salary and equity package (early exercise, extended exercise).
- Great health benefits! (includes health, dental, and vision).
- Unlimited paid time off (PTO) and holiday schedule to support work.
- Regular company off-sites and engineering meetups.