Full Stack Software Engineer

About Alpaca Health

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care. We help clinicians launch and scale their own clinics by providing AI‑powered software, payer contracting, and full back‑office infrastructure. Our goal is to make business ownership possible for every passionate provider. We have raised over $14M in funding and are growing 30% month over month.

We're a tiny engineering team building something large. You would own the platform foundation — data models, money logic, state machines, API contracts, and AI infrastructure. You will design schema migration strategies, build LLM pipelines for clinical documentation, debug billing edge cases, and ensure providers get paid accurately and on time.

• AI‑Native Clinical Workflows – build products that assist with clinical documentation, treatment planning, reassessments, supervision, and administrative work.
• Revenue & Payments Infrastructure – determine how services are authorized, billed, adjudicated, and paid.
• Provider Business Operations – build tools for credentialing, contracting, compliance, payroll, scheduling, and staffing.
• Patient & Family Experiences – design products families interact with from intake to payments.
• Internal Automation Systems – automate operational work across credentialing, billing, authorizations, and care coordination.
• Platform Foundations – own data models, APIs, security, compliance, reliability, AI infrastructure, and production systems.

• Experience in domains where mistakes matter: fintech, healthcare, insurance, logistics, or other operationally complex fields.
• Think in systems, not features: model states, transitions, in variants, and edge cases.
• Strong product instincts and user‑centric mindset.
• Comfortable in ambiguity, able to start with a loosely written problem and drive execution.
• High ownership: solve problems regardless of organogram.
• AI‑native: actively use AI in workflow and explore new leverage points.
• Balance speed with judgment, avoid technical debt.
• Enjoy learning complex domains such as healthcare regulations and payer rules.
• Passionate about writing code and leading major technical decisions.

• Building AI‑powered products in production.
• Experience with LLM workflows, agents, evals, or developer tooling.
• Modeling complex operational or financial systems.
• Healthcare, EHR, insurance, or revenue cycle experience.
• Ownership of large parts of the product at an early‑stage startup.

Founding engineer autonomy, real ownership, and a company on the road to industry leadership. The decisions made in the next year will shape a long‑term system. Compensation Range: $120K – $200K.