About the Role
Join an early-stage healthtech company as its backend-leaning Founding Engineer. You will own core platform architecture and build reliable systems for medication pricing, claims, and payments, where accuracy and uptime directly affect access to medication and financial operations.
What You'll Do
Own backend APIs, database design, permissions, privacy boundaries, backups, staging, observability, and deployments.
Build and operate a real-time medication pricing system that gathers prices from multiple sources and routes claims to the lowest-cost option.
Manage eligibility and claims workflows connected to an adjudication engine.
Build a claims adjudication engine and validate it against an existing system using replayed claims.
Own payment infrastructure for payments between brokers, the platform, and pharmacies, with demanding uptime requirements.
Make architecture and schema 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, system architecture, and database schema design skills.
Experience building and operating production systems where downtime or errors have direct financial or operational impact, 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.
Experience working as a sole engineer at an early-stage startup, alongside exposure to larger technology organizations.
Sound judgment and confidence to challenge technical decisions constructively; experience scaling systems from hundreds to tens of thousands of users is valued.
Experience outside healthcare, health benefits, and pharmacy is required. A computer science or related degree is a plus.
Compensation & Benefits
Base salary: $210,000 to $260,000 annually. Visa sponsorship is not available.
Location
On-site in New York, New York.