San Francisco, California, United States
Onsite
Mira Mace pairs Medicare beneficiaries with a dedicated healthcare advocate who navigates appointments, insurance, and care coordination on their behalf. Our customers get the support of caring nurses while AI agents handle the tedious backend work — all covered by Medicare.
We've felt the pain ourselves — the endless back-and-forth with insurance, surprise bills, and the lack of clarity when you just need answers. Too many people fall through the cracks, and we're determined to change that.
Today, 24/7 personalized health assistance is only available to the rich or extremely sick. Our vision is for everyone to be able to afford a health assistant who knows your health history deeply, navigates the healthcare system on your behalf, and propels you to become the healthiest version of yourself.
Our founding team brings a mix of strong technical experience from companies like Google, Meta, Dropbox, and Amazon, along with serial startup experience ranging from early bootstrapped ventures to Series D scale-ups. We are backed by Foundation Capital, DefineVC and top Silicon Valley angel investors.
We're looking for an engineer who knows how healthcare systems actually work — and wants to own how our platform connects to all of them.
Our platform exchanges data with the rest of healthcare: electronic health records, clinical partners, insurers and eligibility services, and the systems that get claims paid. Those integrations are how care reaches a customer and how the business gets paid for delivering it. You'd own that surface — the connections we run today, the ones we'll need as we grow, and the revenue cycle that sits on top of them.
We're looking for someone who has spent real time building software in healthcare. You've built and operated integrations with healthcare software vendors, and kept them running once they were live — not consumed an API from a product team. You're comfortable with the billing process end to end, and you can hold a conversation about coverage, coding, claims, and denials without a translator.
Own billing and claims end to end. Build and operate the pipeline that turns delivered care into submitted claims, then follows them through payment, denials, and rework. Make the revenue path observable, auditable, and boringly reliable.
Own our healthcare integrations. Design, build, and run the connections to EHRs, clinical partners, eligibility and benefits services, and claims infrastructure — including the ugly parts: retries, idempotency, partial failures, backfills, and reconciliation.
Model healthcare data correctly. Turn messy external payloads into a clean internal data model that the rest of the product — including our AI systems — can reason over safely.
Build for failure. Third-party systems go down, change behavior without notice, and return data that contradicts their own docs. Build the monitoring, alerting, and reconciliation that catches this before a user does.
Be the domain expert in the room. Help the team reason about coverage, coding, claims, and clinical data flow, and push back when a design won't survive contact with the real world.
Decide what to build and what to buy. This space has vendors for almost everything. Evaluate honestly, commit clearly, and own the outcome.
Lay the foundation for scale. Make architectural decisions that hold up as volume grows by orders of magnitude and the number of partners multiplies.
Significant experience building software in healthcare. You understand the domain, not just the code around it.
You've built and operated healthcare integrations in production — EHRs, payers, clearinghouses, eligibility services, labs, or similar. You've owned them on call, not just written the first version.
Hands-on experience with the revenue cycle: claims submission, coding, eligibility and benefits verification, payments and denials, or prior authorization.
Strong backend engineering: API design, data modeling, queues and background jobs, idempotency, and reconciling systems that disagree with each other.
Comfortable with healthcare data standards where they apply (FHIR, HL7, X12, and standard coding systems).
You've worked with PHI under HIPAA and treat security and auditability as part of the design, not a follow-up ticket.
You're comfortable with ambiguity.
Experience with Medicare specifically, including its billing and coding rules.
Experience with post-acute, home-based, or care-transition workflows.
Experience with modern healthcare platforms and APIs (EHR vendors, claims and RCM platforms, eligibility providers).
Python and TypeScript — our stack is FastAPI, Next.js, and Postgres.
Interest in applying LLMs in this domain. We already do, and you'd help push it further.
Beyond technical skills, we're looking for someone who embodies the attributes that make great engineers at an early-stage company:
Proactive. You move quickly and take a forceful stand without being abrasive. You act without being told what to do and bring new ideas to the company.
Analytically sharp. You structure and process qualitative or quantitative data and draw penetrating insights. You learn quickly and absorb new information with ease.
High standards with attention to detail. You expect nothing short of the best from yourself and your team. You don't let important details slip through the cracks or derail a project.
Passionate and open. You exhibit enthusiasm and a can-do attitude over your work. You solicit feedback often and react calmly to criticism or negative feedback.
Everything we do is guided by a set of leadership principles that define how we operate:
Patient First. We start with the patient and work backwards. Every decision — what we build, who we partner with, how we operate — is filtered through one question: does this make the patient's life better?
Sense of Urgency. Every day a patient goes unnavigated is a day someone needing help couldn't get the support they needed. We move fast, make decisions with conviction, and carry urgency toward the long-term vision: an AI nurse concierge in every patient's corner.
Ownership. We see things through. We don't ship and walk away — we own outcomes, not just tasks. We act on behalf of the entire company, beyond just our own area of responsibility. We never say "that's not my job."
Insist on the Highest Standards. We hold ourselves and our teams to nothing short of the best — in clinical quality, in operational execution, in how we show up for patients and partners. We raise the bar continuously.
Question Everything, Unapologetically. We reason from first principles, not precedent. We challenge requirements regardless of who set them, dig until we reach the root of the problem, and resist the pull of "that's how it's always been done."
Mission with massive impact. The systems you build are what let a patient's care actually happen — and what lets us keep the lights on to deliver it.
Own a critical surface outright. Billing, claims, and healthcare integrations are yours. This is a domain where deep expertise compounds, and you'll be the person the company relies on for it.
Learn fast, build fast. We believe in experimentation, measurement, and steady improvement. You'll ship in days, not quarters.
Grow with us. You'll be part of the team that takes Mira Mace from early product to scale. The decisions you make now will define the company's technical DNA.
Meaningful early equity. Competitive compensation and real ownership in what we're building.
Want to know if this job is worth applying to?
