About the Role
Join an early-stage healthtech company as its backend-leaning Founding Engineer. You will own core platform engineering across claims, pricing, and payments, helping ensure people can access their medications reliably.
What You'll Do
Own backend APIs, database design, permissions, PHI boundaries, backups, staging, observability, and deployments.
Build and operate a real-time drug pricing system that regularly gathers prices from multiple sources and routes claims to cost-effective options.
Manage eligibility and claims workflows with a focus on reliability and uninterrupted pharmacy transactions.
Build a claims adjudication engine and validate it against an existing system using replayed claims.
Develop payment infrastructure connecting brokers and pharmacies, with high availability and financial accuracy requirements.
Make architecture and schema decisions that support growth from hundreds to tens of thousands of users and beyond.
What We're Looking For
Three to eight years of experience as a backend or full-stack engineer, with strong backend architecture and database schema design skills.
Experience building and operating production systems where downtime or errors directly affect revenue, such as payments, ledgers, trading, or critical infrastructure.
Comfort working as a sole engineer at an early-stage startup, making architecture decisions, and constructively challenging technical direction.
Proficiency with Python, FastAPI, PostgreSQL, row-level security, GCP, Cloud Run, Cloud SQL, React, and TypeScript.
Experience using AI development tools such as Claude Code or Cursor.
Startup experience, including work outside healthcare, health benefits, and pharmacy. Strong computer science fundamentals are valued.
Must be authorized to work in the United States without visa sponsorship.
Compensation & Benefits
Base salary: $210,000 to $260,000 annually. Visa sponsorship is not available.
Location
On-site in New York, New York.