Principal AI Engineer — Voice & Agentic Systems

At Voxology AI, we’re reimagining patient engagement and access in healthcare through intelligent, AI-driven solutions. Our mission is to help healthcare providers deliver seamless, patient-centered experiences by automating and improving administrative workflows. Our AI agents communicate with patients through natural conversations across voice, text, and chat—reducing hold times, extending access beyond business hours, and creating a more frictionless patient journey. Through deep integrations with leading EMR and EHR platforms, Voxology supports the full patient lifecycle, from initial scheduling and intake to post‑care follow‑up.

Voxology AI is one of the fastest-growing startups in healthcare voice AI, a winner of the KidsX Voice AI Sprint, and backed by Infinx, one of the largest revenue‑cycle management companies in the United States.

We’re hiring a Principal / Staff AI Engineer to join our team full-time and on-site in Austin, Texas.

This is a senior, deeply hands‑on engineering role for someone who has built and scaled complex software systems and wants to define the architecture behind the next generation of healthcare AI agents. You will lead the technical design and development of Voxology’s voice and agentic AI platform, working across AI systems, backend services, infrastructure, data, and user‑facing applications. You’ll collaborate closely with the founding team to translate product and business goals into reliable, secure, and scalable systems.

This role is ideal for an engineer who can move fluidly between architectural decisions and production code, and who wants meaningful influence over the product, platform, and engineering culture.

• Define and evolve the architecture of Voxology’s voice and agentic AI platform.
• Design and build production‑grade AI agents that can reason, use tools, manage state, and execute complex healthcare workflows.
• Develop agent orchestration systems, including tool‑calling, routing, memory, context management, guardrails, retries, and human escalation.
• Build real‑time voice AI experiences involving speech recognition, text‑to‑speech, turn‑taking, interruption handling, and low‑latency conversation management.
• Architect scalable, distributed, and multi‑tenant systems capable of supporting high‑volume patient interactions.
• Build and ship features across the stack using Python, Type Script, React, PostgreSQL, and cloud‑native infrastructure.
• Design APIs, event‑driven services, data pipelines, and integrations with EMR, EHR, telephony, and third‑party healthcare systems.
• Establish evaluation frameworks for agent quality, task completion, hallucination risk, latency, safety, and reliability.
• Improve observability across AI and voice systems through tracing, structured logging, metrics, alerting, and conversation‑level analytics.
• Lead technical design reviews and establish engineering standards for architecture, testing, security, and operational excellence.
• Participate in production ownership, incident response, and continuous improvement of platform reliability.

• 7+ years of professional software engineering experience preferred; 5+ years required.
• Significant experience designing, building, and operating production‑grade, full‑stack software systems.
• Strong experience with modern AI systems, including LLM‑powered applications, agentic workflows, tool‑calling, prompt design, and model orchestration.
• A track record of architecting scalable systems involving distributed services, asynchronous workflows, APIs, databases, and cloud infrastructure.
• Hands‑on experience building conversational AI, voice AI, or real‑time communication systems.
• Strong proficiency in Python and Type Script, with experience shipping user‑facing applications using frameworks such as React.
• Deep knowledge of PostgreSQL, including schema design, indexing, migrations, query optimization, and data integrity.
• Experience designing reliable multi‑tenant applications and secure systems that handle sensitive data.
• Familiarity with AI evaluation, experimentation, model selection, prompt versioning, monitoring, and production debugging.
• Experience with Dev Ops and…