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New York, New York, United States
Hybrid
About the Company
We’re building infrastructure that makes healthcare innovation easier. Our customers already serve 3+ million patients and manage $15+ billion in annual medical spend. Today, we work with leading healthcare groups backed by top Silicon Valley investors such as Sequoia, General Catalyst, Y Combinator, Kleiner Perkins, Stanford, Khosla Ventures, and others. Our mission is to enable more innovation in healthcare—so more patients receive affordable care.
About our Team
Our leadership previously founded and led a national digital health company (>$15M raised), with a team of 100+ employees across the US and that sold to a 1,000+-person incumbent. We’re a tight-knit team that’s driven to move fast and take on some of the biggest problems in healthcare and ultimately improve patient lives.
About the Role
As our business grows, we're looking for a Software Engineer who will own our internal tools, client-facing products, and infrastructure underlying our operations.
You'll be our founding offshore engineer, working async with a US-based operations team to build the data architecture, integrations, internal tools, automations, and agents that operations runs on. One month you might stand up a clean data model and sync it across our tools; the next, build an internal console the ops team uses daily; the next, ship an AI agent that drafts, triages, or matches — and earns enough trust to run with light human review. You'll go deep enough to understand each operational workflow, then replace it with a system that runs better without you. Backend and data are the core; you'll build serviceable internal UIs when needed (AI-assisted is fine), with correctness and reliability mattering more than polish
What You’ll Own:
Own the data architecture — the entities, relationships, and sources of truth behind physician sourcing/matching, client onboarding, PC-MSO structures, and billing state — and keep it clean as requirements change.
Build and harden integrations between our systems (CRM, e-sign/DocuSign, scheduling, spreadsheets, Google Workspace, our datastore) so data flows reliably instead of by hand — with sane handling of auth, webhooks, rate limits, retries, and idempotency.
Replace manual ops work with automations and AI agents — and make them observable and trustworthy enough to run with minimal supervision.
Build lightweight internal tools the ops team uses to run the business; ship serviceable client-facing UI when needed (AI-assisted acceptable, behind a review gate when durable).
Take an ambiguous operational need from a non-engineer stakeholder, clarify the real requirement, scope pragmatically, ship it, and own it in production — monitoring, fixing, and documenting as you go.
Instrument the business — the pipelines and definitions behind the metrics and dashboards ops and leadership run on.
Key Performance Indicators
In your first 6-12 months, you will have (outcomes, not activities):
Stood up a clean, documented data model plus the integrations that keep it current — the trusted source of truth for at least one core domain (e.g., physician supply, client onboarding).
Shipped at least one automation or agent that removed meaningful recurring manual effort and runs reliably with only light human review.
Delivered at least one internal tool the ops team uses daily to run the business without you in the room.
Left systems documented and observable enough that a teammate — or the next engineer — can run and extend them.
About You
Core Experience
5+ years building and shipping production backend / data / integration systems, with real ownership (not just closing feature tickets).
Strong at data modeling and systems design — you design schemas and services that survive changing requirements and messy real-world data.
Fluent with integrations — third-party APIs, webhooks, auth, rate limits, and the failure modes of syncing systems.
Pragmatic — you scope to the outcome and ship the right-sized thing; comfortable doing something by hand first, then automating it; you don't gold-plate.
High-ownership and autonomous — you run independently across a timezone offset, without a manager in the room, and you finish.
Excellent written communicator in English — you work async, write clear docs and PRs, and translate between ambiguous ops language and technical reality.
AI-native — you use AI to build faster and to build agents, and you know when to trust it and when to override it. You stay accountable for what ships.
Trustworthy with sensitive data — you understand why handling healthcare-adjacent PII and legal documents carefully matters.
Bonus:
Built internal tooling / automations / AI agents in a startup or ops-heavy environment.
Healthcare, fintech, legal-tech, or another compliance-heavy / operationally intensive domain.
Full-stack enough to build a serviceable UI when the moment calls for it.
First / founding engineer experience, or a track record of setting up systems from scratch.
Several hours of daily overlap with US working hours.
What You Bring
Energy and drive; you have a hunger for self-improvement and want to be around the most talented teammates who push you to do so. (Kobe said it best.)
Excited by a fast-paced, startup culture where you’ll navigate ambiguity and solve big problems, with very high autonomy.
Talent for identifying process improvement opportunities and creative ways to better structure operations.
Interest in working in healthcare and helping healthcare innovation flourish.
What We Offer
Highly competitive salary and stock options (we want you to share in our growth)
Compassionate, fun, and mission-driven culture of excellence and innovation. (We help companies bring new life-changing care models into the world.)
Many growth and advancement opportunities (the company is growing fast, so there are many opportunities to step up).
Hybrid set-up. Preference for either New York or Toronto, but open to elsewhere.
Paid Time Off: Holidays, vacation days.
Comprehensive health plans so you feel your best.
Culture of mentorship, learning, independence, and critical-thinking.
This role has a preference for Eastern Time (EST) hours (some flexibility there)