IT & Automation Lead

Location

San Francisco

Full time

Engineering

About Us:

Ambience Healthcare is the leading AI platform for documentation, coding, and clinical workflow, built to reduce administrative burden and protect revenue integrity at the point of care. Trusted by top health systems across North America, Ambience’s platform is live across outpatient, emergency, and inpatient settings, supporting more than 100 specialties with real-time, coding-aware documentation. The platform integrates directly with Epic, Oracle Cerner, athenahealth, and other major EHRs.

Founded in 2020 by Mike Ng and Nikhil Buduma, Ambience is headquartered in San Francisco and backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, Kleiner Perkins, and other leading investors.

Join us in the endeavor of accelerating the path to safe & useful clinical super intelligence by becoming part of our community of problem solvers, technologists, clinicians, and innovators.

Ambience is scaling fast, and our internal systems need to keep up — securely, automatically, and without slowing anyone down.

You’ll be our first dedicated Corporate IT Lead, owning identity, devices, endpoints, and SaaS access across the company. This is not a ticket-queue role. You’ll build the automation and infrastructure that makes IT disappear for employees while raising the security bar across the board.

You’ll design identity and device systems that scale with headcount, enforce least-privilege by default, and turn manual IT work into code. The goal: secure, compliant internal systems that people don’t think about — because they just work.

Our roles are hybrid in our SF office (3x/week).

Identity & Access Automation — Build Okta joiner/mover/leaver workflows with role-based access, automated provisioning, and clean offboarding. Kill standing access and manual tickets.

Device Management & Endpoint Security — Run Jamf and Intune in a mixed Mac/Windows environment. Zero-touch provisioning, compliance baselines, patching, and end-to-end Zero Trust.

AI-Forward Operations — Improve the customer and employee experience through AI-driven ticketing, intelligent bots, and automated workflows that reduce resolution time and cut manual toil.

Infrastructure as Code — Move IT configs out of admin consoles into Terraform and Git Ops. Version-controlled, peer-reviewed, reproducible changes across identity, MDM, and workspace systems.

SaaS Governance — SaaS inventory:
Provisioning, tools, access, cost, and security reviews and posture. Surface shadow IT, consolidate sprawl, and run access reviews.

7+ years building IT and/or corporate security systems at a startup or high-growth company

Deep Okta experience beyond admin work — you’ve deployed advanced identity programs

Strong hands-on Jamf and Intune experience in Mac/Windows environments

Automation-first:
Terraform, APIs, scripting (Python, Bash, Power Shell), Workflow automation

Comfortable operating across security, IT, and engineering boundaries

Technology person at heart with a passion for the space and does not just see IT as a job

In SF, 3x/week in-person

At Ambience, IT is foundational. The systems you build determine how safely we operate, how fast teams move, and how confidently we scale inside regulated healthcare environments.

You’ll own this function end-to-end at a critical growth moment, with real autonomy, direct access to leadership, and the mandate to replace chaos with clean, automated systems. Small team, high trust, real impact.

Pay Transparency
We offer a base compensation range of approximately $200,000–$225,000 per year, along with meaningful equity. This intentionally broad range provides flexibility for candidates to tailor their cash and equity mix based on individual preferences. Our compensation philosophy prioritizes meaningful equity grants, enabling team members to share directly in the impact they help create. If your expectations fall outside of this range, we still encourage you to apply—our approach to compensation considers a range of factors to ensure alignment with each candidate's unique needs and preferences.

Being at Ambience:

• An…