Founding Engineer

ABOUT THE ROLE

Join an early-stage healthtech company as a backend-leaning Founding Engineer, owning core infrastructure and architecture. You will build reliable systems for drug pricing, claims, and payments where errors can affect access to medication and the movement of funds.

WHAT YOU'LL DO

• Own backend APIs, data models, permissions, PHI boundaries, backups, staging, observability, and deployments.
• Build and operate a real-time drug pricing system that gathers prices from multiple sources and routes claims to the lowest-cost option.
• Manage eligibility and claims flows through an adjudication engine, maintaining dependable service for pharmacy transactions.
• Develop an in-house claims adjudication engine and validate its results against an existing system using replayed claims.
• Build and operate payments infrastructure connecting brokers and pharmacies, with stringent uptime requirements.
• Make architecture and schema decisions that support growth from hundreds to tens of thousands of users.

WHAT WE'RE LOOKING FOR

• Three to eight years of backend or full-stack engineering experience, with strong backend, system architecture, and database design skills.
• Experience owning production systems where errors or downtime directly affect revenue, ideally in payments, ledgers, trading, or critical infrastructure.
• Proficiency with Python, FastAPI, PostgreSQL, row-level security, GCP, Cloud Run, Cloud SQL, React, and TypeScript.
• Experience operating as a sole engineer or working at an early-stage startup, alongside exposure to larger technology organizations.
• Comfort making independent architecture decisions, constructively challenging technical leaders, and using AI development tools such as Claude Code or Cursor.
• Software engineering experience outside healthcare, health benefits, and pharmacy; a computer science or related degree is a plus.

COMPENSATION & BENEFITS

Base salary: $210,000 to $260,000 annually. Visa sponsorship is not available.

LOCATION

On-site in New York, New York, United States.