Founding Engineer Healthcare Platform

What you’ll build. One core platform — auth, multi-tenancy, a canonical clinical event store, audit logging, HIPAA infrastructure, model serving — with vertical applications launched on top of it, one specialty at a time. The architecture already anticipates this: everything downstream consumes a canonical event schema, so each new vertical is a configuration and a front-end, not a new codebase.

Where the role goes. This is not a build-one-app job. The company operates as a foundry, spinning up 4–6 companies per year on the shared platform, and the tech organization will grow accordingly. You start as engineer #1 with total technical ownership — you pick the stack, you own the architecture, you hire engineer #2. As the foundry scales, the tech organization expands with it, and scope in that organization is earned, not promised: ambition, drive, trustworthiness, and above all velocity of delivery are what determine how big your role becomes. For someone who consistently ships, the upside is enormous — being #1 in an organization built to keep growing means something different than it does at a single-product startup. No title is guaranteed on day one; the chance to earn a big one is.

Who you are. 7–12+ years, full-stack, and you have personally shipped production systems that handled real PHI, end to end, more than once. You can talk BAAs, audit-log design, AWS HIPAA-eligible services, and SOC 2 from experience rather than from a checklist. You’ve been engineer #1–3 somewhere before, so you know what it costs and what it pays. You’re a pragmatist who works from written specs and acceptance tests. Bonus: FHIR/HL7, EHR integrations, or clinical documentation pipelines.