Founding Head of Engineering

Founding Head of Engineering

VC Funded HealthTech · San Francisco (preferred) / Remote · Full-time · Founding Team

Our client is building an AI-powered decision engine for healthcare billing disputes, automating the arbitration process between hospitals/doctors and insurance companies. We’re backed by a well known Venture Studio (with a successful track record) and are partnered with a law firm providing \~$400M of claims as both training data and initial revenue, plus early provider/hospital network partners.

Role

We’re hiring our first engineer (de-facto Head of Engineering) as a founding team member. You’ll own the end-to-end build of our initial platform and help shape the technical direction and engineering culture.

What You’ll Do

• Design and build the core platform: APIs, data models, workflow/state machine, and UI
• Implement a claims workflow supporting human-in-the-loop operations
• Gradually automate manual steps using LLMs and standard automation tools
• Contribute to the decision engine that selects which claims to contest, how, and for how much
• Establish engineering best practices (testing, monitoring, security)
• Partner closely with the founder on product decisions and future hiring

What We’re Looking For

• 7\+ years software engineering experience, including:
• Strong full-stack skills (backend-heavy, competent frontend)
• Experience at a SaaS/product company
• Startup or zero-to-one experience (early-stage, high ambiguity)
• Solid grounding in:
• Databases, application architecture, distributed systems basics
• Workflow/state machines, queues, or operations-heavy systems
• 1–2\+ years working with LLMs/AI features in a product (agentic or workflow automation a plus)
• Hands-on: comfortable shipping code \~50%\+ of your time while owning architecture
• Bias toward startup pace and ownership over large, process-heavy environments
• Curiosity and enthusiasm for rapidly evolving AI tooling

Nice to Have

• Experience in healthcare, insurance, or regulated environments
• Prior founding/early-engineer experience