AI-assisted — A standard engineering role where AI tools are a bonus on top. It still expects real engineering depth.
Join an early-stage healthtech software startup as a backend-focused founding engineer. You will own core platform architecture and build reliable systems that help ensure people can access their medications.
Own backend APIs, database design, permissions, data boundaries, backups, staging, observability, and deployments.
Build a real-time medication pricing system that compares multiple sources and routes claims to cost-effective options.
Manage eligibility and claims workflows, helping ensure reliable service at the pharmacy counter.
Build a claims adjudication engine and validate its results against an existing system using replayed claims.
Own payment infrastructure between business partners and pharmacies, with a focus on reliability and accuracy.
Make architecture and schema decisions that support growth from an early user base to a larger platform.
Three to eight years of backend or full-stack engineering experience, including architecture, production systems, and database schema design.
Experience operating systems where downtime or errors have direct financial or operational impact, such as payments or financial infrastructure.
Proficiency with Python, FastAPI, PostgreSQL, Row-Level Security, GCP, Cloud Run, Cloud SQL, React, and TypeScript.
Comfort using AI development tools such as Claude Code or Cursor.
Strong technical judgment, clear communication, and confidence challenging assumptions constructively.
Fintech or infrastructure startup experience is a plus. Prior healthcare, health benefits, or pharmacy software experience is not needed.
Salary range: $210,000 to $260,000 annually. Visa sponsorship is not available.
On-site in New York, New York, United States.