Founding Engineer

About the Role

Join an early-stage healthtech team as its backend-leaning Founding Engineer. You will build and operate the core platform for real-time prescription pricing, claims processing, and payments, where reliability directly affects access to medication and financial transactions.

What You'll Do

• Own backend APIs, database design, access controls, sensitive health data boundaries, backups, staging, observability, and deployments.
• Build a real-time pricing system that gathers prices from multiple sources and routes claims to the lowest-cost option.
• Manage eligibility and claims workflows connected to a claims adjudication system.
• Develop an in-house claims adjudication engine and validate its results against a current system using replayed claims.
• Build and operate payment infrastructure for transactions between business partners and pharmacies, targeting 99.99% uptime.
• Make architecture and data model decisions that support growth from hundreds to tens of thousands of users.

What We're Looking For

• 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 errors or downtime have direct financial or operational consequences, such as payments, ledgers, trading, or critical infrastructure.
• 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.
• Startup experience, ideally including operating as a sole engineer and making systems architecture decisions as a product scales.
• Ability to communicate candidly and challenge technical decisions when needed.
• Experience outside healthcare, health benefits, and pharmacy, plus a computer science or related degree, is a plus.
• Must be able to work in person in New York and have work authorization that does not require employer visa sponsorship.

Compensation & Benefits

Base salary

$210,000 to $260,000 USD annually. Visa sponsorship is not available.

Location

On-site in New York, United States.