Founding Engineer

You'd be the second engineer at a seed‑stage healthtech in New York. This Founding Engineer role means owning the data platform and architecture underneath the product, not picking up tickets. $170,000 to $220,000 plus founding equity.

It is building an AI financial analyst for specialty medical groups. It pulls claims, remittances and payer contracts out of disconnected systems and turns them into cited answers for the CFO's office, including where payers have underpaid. It keeps a quarter of every underpaid dollar it finds. The first customer goes live in early November. The seed round gives you over four years of runway, even with you on the payroll and no revenue.

The founders set the outcome. You work out the best route, propose it, and build it. Within 90 days you'll own end-to-end pieces and take work off the founder's plate:

• Ingestion: claims and remittances, payer contracts and price transparency files into a Postgres warehouse with dbt.
• Contract intelligence: LLMs read unstructured payer contracts (PDFs, scans) and extract rates and terms. Embeddings and vector search link every answer to the exact clause.
• Agents on AWS Bedrock with guardrails, provenance and evals.
• Infrastructure through Terraform, ECS and Git Hub Actions, with shared ownership of production.

• 4+ years building and running production software, ideally with a founding or early-startup stretch
• Strong Python and SQL, and a data-intensive system you've owned end to end
• Shipped LLM features: document extraction, embeddings, RAG, evals
• Architecture-level thinking. The language matters less than how you design the system
• Daily use of Claude Code, Cursor or Codex, and the judgement to verify what they write

Healthcare experience is a plus, not a requirement. They'll teach you the domain. No visa sponsorship.

$170k to $220k plus equity at seed‑stage prices. The plan is Series A with one more engineer, not six, so each hire is paid properly. Advisors include a former CIO of a leading US health system and the founder of a patient-payments company now worth billions. The culture rule: say so when something is wrong, especially when it's hard.