Founding Full-Stack Engineer

We’re building a revenue cycle orchestrator on top of Attune’s Agentic Voice platform: claims files come in, get enriched through RAG and EHR/payor integrations, and turn into supervised actions—payor calls, member outreach, appeal packets. This role owns the backbone that ties it together: the workflow engine that sequences those actions and the state that drives the human-in-the-loop portal.

You’ll be one of three founding engineers. Expect to make foundational architecture decisions, write production code across the stack, and shape how the whole product hangs together.

• Design and build the workflow orchestration layer: how a claim moves through states, when actions fire, how human approvals gate progress, and how it all stays auditable.
• Build the services behind the approve / deny / kick‑off experience—the queues, the state machine, and the APIs the portal runs on.
• Integrate with Attune’s voice and agentic APIs to launch and track payor and member calls as first‑class workflow actions.
• Make reliability and observability a feature, not an afterthought—retries, idempotency, and clear audit trails in a domain where correctness is money.
• Partner closely with the product lead and the other founding engineers; move fast without leaving a mess.

• 6+ years building production full-stack software; comfortable owning a service end to end from schema to UI-facing API.
• Strong backend fundamentals: workflow/state-machine design, event-driven systems, queues, and data modeling for complex domains.
• Experience with long-running, multi-step processes and human-in-the-loop or approval workflows.
• Pragmatic full-stack range: primarily backend, but able to build and reason about the front end the portal needs.
• Track record in an early-stage or founding-engineer setting: high autonomy, ambiguous specs, shipping under real constraints.

• Exposure to Lang Graph, deterministic orchestration, or agentic/multi-step LLM workflows.
• Healthcare or other regulated, high-reliability domains (HIPAA/PHI, audit requirements).
• Familiarity with claims, RCM, or other document-and-approval-heavy back-office workflows.

• Small, cross-functional founding pod with a tech lead and a product lead—little overhead, high ownership.
• Self-hosted PHI architecture, Lang Graph orchestration, and a strong bar for reliability in a regulated domain.
• High autonomy, high bar, candid feedback, low politics.
• Hybrid: 3 days/week in our West Loop office; occasional travel for customer meetings and team onsites.

Attune is an equal opportunity employer. We celebrate diversity and are committed to an inclusive environment for all employees.