Founding Engineer, Backend & Infra

About the Role

This is a founding backend engineering role at an early-stage healthtech company building a clinical AI platform for healthcare payments. You will own and scale the core distributed systems that power clinical and financial workflows, working closely with the founding team to shape the engineering foundation from the ground up.

What You'll Do

• Build and scale distributed backend systems supporting chart data processing, claims workflows, authorization and denial pipelines, and payer/provider integrations.

• Own browser-use and computer-use systems that navigate complex medical record software and payer portals.

• Design reliable infrastructure for messy healthcare data at high volume, including scanned charts, PDFs, structured claims, and unstructured clinical notes.

• Build orchestration, queuing, retry, and observability infrastructure for long-running, failure-prone workflows across EHRs, clearinghouses, and payer systems.

• Partner with research and product engineers to bring new clinical intelligence capabilities into production, setting patterns that future engineers will build on.

What We're Looking For

• 3+ years of backend or infrastructure engineering experience, ideally at a company known for high engineering standards.

• Strong command of Python and distributed systems design.

• Hands-on experience with microservices, data pipelines, orchestration, and backend infrastructure.

• Comfort working with browser automation, LLM integrations, or agentic workflows is a strong plus.

• Systems thinker who can design and implement complex backend architecture end-to-end with minimal direction.

• Experience in healthtech, healthcare data (EHRs, claims, payer systems), or similarly regulated and data-intensive domains is a plus.

• Ability to operate with a high degree of ownership and ambiguity in an early-stage environment.

Compensation & Benefits

Base salary: $160,000 to $200,000 USD annually. Equity participation is expected at the founding stage. Visa sponsorship is not available for this role.

Location

On-site in San Francisco, CA, United States.