Founding Engineer

Role details

ABOUT THE ROLE Join an early-stage healthtech company as its founding engineer, owning the backend and core platform architecture. You will work closely with the technical founder to build reliable systems for prescription pricing, claims processing, and payments, where correctness and availability directly affect patients and business operations. WHAT YOU'LL DO - Own backend APIs, database design, permissions, sensitive health information boundaries, backups, staging, observability, and deployments. - Build and operate a real-time drug pricing system that gathers prices from multiple sources and routes claims to cost-effective options. - Manage eligibility and claims flowing through an adjudication engine, and build an in-house engine validated against the existing system using replayed claims. - Own payment infrastructure for payments to and from pharmacies, with a focus on reliability and correctness. - Make foundational architecture and schema decisions that support growth from an early user base to tens of thousands of users. WHAT WE'RE LOOKING FOR - Three to eight years of experience as a backend or full-stack engineer, including ownership of production systems where errors or downtime have a direct business impact. - Strong backend architecture, system design, and database schema skills, with experience in payments, ledgers, trading, or critical infrastructure. - Experience operating as a sole engineer at an early-stage startup and making pragmatic decisions as systems scale. - Proficiency with Python, FastAPI, PostgreSQL, row-level security, GCP, Cloud Run, Cloud SQL, React, and TypeScript. - Comfort using AI development tools such as Claude Code or Cursor, and communicating technical concerns directly with founders. - Strong computer science fundamentals or a related degree. COMPENSATION & BENEFITS Annual salary: $210,000 to $260,000. Visa sponsorship is not available. LOCATION On-site in New York, New York, United States.