Founding Engineer

Join an early-stage healthtech team as its founding backend-leaning engineer. You will shape the platform’s architecture and build reliable systems for drug pricing, claims, and payments, where errors can directly affect access to medication and financial transactions. What You’ll Do

• Own backend APIs, database design, permissions, sensitive health data 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 low-cost options.
• Manage eligibility and claims flows through an adjudication system, and build a replacement that can be validated against the existing system using replayed claims.
• Own payment infrastructure connecting brokers and pharmacies, with a high bar for availability and reliability.
• Make foundational architecture and schema decisions that support the platform as it grows.

• Three to eight years of backend or full-stack engineering experience, with strong backend, architecture, and database schema design skills.
• Experience building and operating production systems where downtime or errors have a direct financial impact.
• 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 and Cursor.
• Fintech or infrastructure startup experience is a plus. Candidates should have startup exposure beyond experience solely at large technology companies.
• Strong technical judgment and confidence to challenge assumptions and offer direct feedback.
• Experience outside healthcare, health benefits, or pharmacy software.