Founding AI Engineer

Founding AI Engineer (Healthcare)

Location: New York City — On-site

Employment: Full-time | Team: Founding Engineering

Compensation: $200,000–$350,000 + meaningful equity

Why this role

We’re building an AI doctor platform from first principles. As our Founding AI Engineer, you’ll take true end-to-end ownership—turning clinical insight into shipped, safety-critical systems that deliver diagnostic reasoning, chronic disease management, and HIPAA-grade data processing at scale. You’ll set the technical bar, the patterns, and the culture for how we ship life-saving software.

What you’ll own (zero → one → scale)

Architecture & Product

• Design the core multi-agent engine where specialist models debate, reconcile, and explain decisions.
• Stand up RAG at scale, rebuilding clinical guidelines for LLM consumption and provenance tracking.
• Ship real-time inference paths that keep latency low while supporting millions of daily consults.
• Author domain workflows—condition/specialty reasoning chains with explicit safety rails.

Clinical Data & Integrations

• HIPAA-compliant NLP to structure patient conversations with auditability and PHI minimization.
• EHR connectivity (QHINs, FHIR/HL7) for automated retrieval, reconciliation, and longitudinal context.
• Intelligent triage that routes cases between AI and clinicians via calibrated complexity scores.
• Auto-documentation that fits provider protocols and coding requirements out of the box.

Safety & Reliability

• Human-in-the-loop escalation in sub-seconds for emergencies.
• Validation layers that target 99%+ plan accuracy against clinical standards with continuous QA.
• Distributed systems that fail safe, degrade gracefully, and handle spiky, hyper-growth traffic.
• Operational rigor: red-team prompts, bias detection, drift monitoring, and post-incident learning.

And beyond

Voice/video interfaces, multilingual medical NLP, predictive health modeling, and the platform for the next billion patient interactions. You’ll choose the stack, automate the pipeline, and keep the lights on.

What great looks like

• 7+ years building production systems; expert with LLMs/gen-AI (OpenAI, Anthropic, LLaMA, etc.).
• Fluency in Python and TensorFlow/PyTorch; strong on prompt design, fine-tuning, and optimization.
• You’ve shipped real-time AI services and owned the reliability envelope (SLOs, on-call, observability).
• Startup DNA: founder/founding engineer experience or deep early-stage ownership.

Bonus points

• Healthcare/med-tech background; HL7/FHIR, clinical workflows, regulated environments.
• Safety, bias/fairness work in medical AI; domain NLP research/implementation; publications a plus.
• Seed/Series A experience; advanced degree in CS/AI/ML (nice to have, not required).

How you’ll work

• Sit with PM/clinical advisors to turn ambiguous problems into testable specs.
• Pair with engineers to build the first correct version, then harden and scale.
• Write design docs, instrument everything, run experiments, and ship weekly.
• Mentor the next hires; help define our hiring rubric, code standards, and safety gates.

What we offer

• Founder-level ownership (meaningful equity) and direct line to the CEO.
• A wedge into a market measured in lives improved, not just MAUs.
• Access to top clinical advisors and the newest models/tooling.
• Competitive salary, benefits reimbursement, and the autonomy to do the best work of your career.

If you want to architect the brain—and the guardrails—of safe medical AI from day one, let’s talk.