Founding Engineer

ABOUT THE ROLE

Join an early-stage healthtech team as its backend-leaning Founding Engineer. You will own core platform architecture and build reliable systems that support medication pricing, claims processing, and payments.

WHAT YOU'LL DO

• Own backend APIs, database design, permissions, sensitive health data 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 workflows connected to an adjudication engine, where reliability is essential for patients accessing medication.
• Build a claims adjudication engine and compare its results with an existing system using replayed claims.
• Own payment flows between brokers, the platform, and pharmacies, with demanding uptime and financial accuracy 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 schema design skills.
• Experience operating production systems where downtime or errors 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 at an early-stage startup, including operating as a sole engineer, and exposure to larger technology organizations.
• Comfort making architecture decisions, using AI development tools such as Claude Code or Cursor, and constructively challenging technical decisions.
• Experience outside healthcare, health benefits, and pharmacy; strong computer science fundamentals are valued.

COMPENSATION & BENEFITS

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

LOCATION

On-site in New York, New York.