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Founding Engineer

  • New York, NY, United States

$210,000 to $260,000 USD / year

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Job details

Pay
$210,000 to $260,000 USD / year
Posting language
English
Posted

Original job description

ABOUT THE ROLE

Join an early-stage healthtech company as a backend-leaning Founding Engineer. You will own core engineering systems that support real-time prescription pricing, claims processing, and reliable payments, helping ensure patients can access their medication.

WHAT YOU'LL DO

  • Own the backend, including APIs, database design, permissions, protected health information 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 flowing through an adjudication engine, keeping failures from disrupting pharmacy transactions.
  • Build a claims adjudication engine and validate it against the existing system using replayed real claims.
  • Develop and maintain payment infrastructure for payments between brokers, the platform, and pharmacies.
  • Make architecture and schema decisions that support growth from hundreds to tens of thousands of users and beyond.

WHAT WE'RE LOOKING FOR

  • Three to eight years of experience as a backend or full-stack engineer, with strong backend and system architecture skills.
  • Experience building and operating production systems where errors or downtime have direct financial or operational impact, such as payments, ledgers, trading, or critical infrastructure.
  • Proficiency with Python, FastAPI, PostgreSQL, row-level security, GCP, Cloud Run, Cloud SQL, React, and TypeScript.
  • Experience making database schema and architecture decisions, ideally as a sole engineer at an early-stage startup.
  • Comfort challenging technical decisions and communicating directly with a strong-opinioned founder.
  • Familiarity with AI development tools such as Claude Code or Cursor.
  • Startup experience alongside larger-company experience is valuable. Experience outside healthcare, health benefits, and pharmacy is required.

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.

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