Founding Head of Engineering

Our client is building an AI-enabled Managed Services Organization (MSO) for hospitals in Spanish-speaking LATAM, starting with Revenue Cycle Management (RCM) as the entry wedge.

Hospitals across LATAM operate in highly fragmented revenue environments. Claims are rejected (glosas), documentation is incomplete, billing is delayed, A/R extends beyond 180–360 days, and administrative processes are manual and Excel-heavy.

Our client is not building a simple SaaS billing product.
Our client is not building a labor-arbitrage BPO.

Our client is building the operating system that runs hospital revenue workflows end-to-end, combining:

• Managed services (they take responsibility for outcomes)
• Structured workflow systems
• Embedded intelligence
• Over time, selective risk-based pricing

Technology is the leverage layer that makes this scalable and defensible.

This is a pre‑seed company. This will be their first senior technical leader.

Design and build the foundational technical system that converts messy, manual hospital revenue workflows into a structured, measurable, and increasingly intelligent operating engine.

Within 6 months, this person must transform RCM delivery from “people + spreadsheets” into a real internal system with:

• Canonical lifecycle tracking
• Workflow orchestration
• Measurable accountability

This is not a back‑office engineering role.

Similar to a Forward Deployed Engineer profile, this person must spend meaningful time working directly with hospital clients and internal RCM teams to deeply understand real workflows before abstracting them into systems.

This role determines whether the company becomes a scalable platform or a labor‑heavy services business.

This role is hands‑on and execution‑heavy in Year 1.

Design and implement:

• Every claim/account has a clear lifecycle state
• Every action is logged
• Time‑in‑state is tracked
• Financial impact is measurable
• Evidence and documentation are attached

This becomes the single source of truth across hospitals.

• Structured work queues
• Case routing logic
• SLA enforcement
• Ownership tracking
• QA sampling capability
• Audit trails

The goal: internal teams prefer this system over Excel.

This person must design pragmatic ingestion systems that:

• Accept flat files
• Integrate via APIs when possible
• Tolerate incomplete or messy inputs

Clean infrastructure cannot be assumed.

Early versions may be rule‑based.

Must enable:

• Denial classification
• A/R prioritization scoring
• Next‑best‑action suggestions

The long‑term moat is outcome‑labeled learning across hospitals.

This person must:

• Sit with RCM operators
• Translate messy processes into clean system logic
• Join hospital onboarding calls when needed
• Make pragmatic integration decisions

They must be comfortable in client‑facing technical conversations.

In Year 1, this person will:

• Write production code
• Set the technical quality bar

This is not a manager‑only role.

Success in this role will be evaluated through progressive, time‑based milestones that demonstrate increasing structure, visibility, and automation across hospital revenue operations.

During the first three months, the focus is on converting ambiguity into structure.

By this stage:

• The architecture for the canonical RCM event ledger is defined and implemented.
• At least one hospital’s data is successfully ingested into the system.
• A lifecycle state machine is operational and tracking claims across defined states.
• Work queue routing is live with basic ownership and SLA logic.
• A production dashboard provides visibility into:
  • Claims by lifecycle state
  • Aging buckets
  • SLA performance
• Initial denial classification logic is implemented (rule‑based is acceptable).
• A clear 6‑month technical roadmap is finalized.

Operational impact expected at this stage:

• Reduced ambiguity in claim ownership.
• Early visibility into bottlenecks and aging patterns.

Between months four and…