Senior Founding Engineer, Platform

Company Description

Our client is a fast-growing healthcare AI company building the operating system for autism care.

The company provides AI-powered infrastructure that enables clinicians to start, run, and scale autism therapy practices by automating core operational workflows including billing, scheduling, payroll, documentation, and patient communication.

The company has seen rapid traction, growing ~30% month-over-month and already supporting hundreds of children across dozens of clinics. In under a year, they have scaled from zero to multi-million dollar revenue and raised a $10M Series A.

Backed by top-tier investors and experienced operators, the company is building foundational infrastructure for modern autism care delivery --- combining healthcare operations with AI-driven automation.

What You Will Do

• Lead architecture and execution of core platform systems powering healthcare operations
• Own backend systems for payouts, payroll, billing, and financial infrastructure
• Design and maintain core data models, state machines, and system logic
• Build production-grade backend services in Python (70--90% backend focus)
• Design schema migrations and evolve production systems safely
• Build infrastructure for LLM-powered clinical workflows
• Ensure systems are auditable, reliable, and HIPAA-compliant
• Design APIs and backend contracts for platform features
• Work closely with product and clinical operations teams
• Own platform stability and system correctness end-to-end
• Make architectural decisions for scalability and long-term reliability
• Help stabilize early-stage production systems under rapid growth

Ideal Candidate Background

• 4--10 years of backend or fullstack engineering experience
• Strong Python backend experience in production systems
• Experience in high-accuracy environments (fintech, healthcare, insurance)
• Strong system design and architecture experience
• Experience building production APIs and backend services
• Strong data modeling and database design skills
• Experience at Series A--C or high-growth startups
• Ability to work independently with minimal guidance

Preferred

• Fintech, healthcare, or regulated systems experience
• Stripe, Brex, Ramp, Plaid, Gusto, or similar companies
• Healthcare tech experience (Grow Therapy, Headway, Candid Health, etc.)
• Experience with NoSQL (MongoDB, Firebase, etc.)
• Exposure to LLMs or AI systems in production
• Event-driven systems or state machine design
• Financial systems (ledger, payroll, payouts) experience

Strong Signals

• Strong backend ownership in production systems
• Experience building correctness-critical infrastructure
• Stripe / Brex / Ramp / Plaid-type engineering background
• Healthcare or fintech domain exposure
• Strong CS fundamentals and system design ability
• Ownership of architecture decisions in prior roles
• Experience shipping in fast-growing startups
• High attention to detail and production rigor

Compensation and Benefits

• Base salary: $160,000 -- $200,000
• Equity: Competitive early-stage equity
• Hybrid work: 3 days/week onsite in NYC or SF
• Relocation support available
• High ownership founding engineer role
• Direct access to founders and leadership
• Opportunity to define core platform architecture

Why Join

• This is a high-impact founding engineering role building the core systems behind healthcare operations for autism care providers.
• You will own the platform architecture powering billing, payroll, scheduling, and clinical workflows used in real production environments.
• This role offers the opportunity to build foundational infrastructure in a fast-growing, mission-critical healthcare domain with strong real-world impact.

Location: New York / San Francisco / Remote (Hybrid -- 3 days/week onsite in NY or SF) Company Stage of Funding: Series A (~$12M raised) Office Type: Hybrid Salary: $160,000 -- $200,000 + Competitive Equity Visa: Visa sponsorship not available (relocation support available)