Remote job
Founding Software Engineer
Job details
About this role
Role overview
This is a founding software engineering seat at a pre-revenue healthcare infrastructure startup building AI-driven automation for the prior authorization lifecycle. The platform connects to electronic health record (EHR) systems, extracts clinical data, formats and submits authorization requests to payers, tracks status, and closes the loop back into clinic workflows. The role is remote with US hours overlap required.
Responsibilities
- Design and build the core platform, including FHIR-native EHR integrations, prior authorization submission workflows, payer connectivity, and supporting data pipelines. - Own integrations end-to-end, including navigating EHR FHIR API quirks, handling X12 278 transaction edge cases, and recovering gracefully when payer portals behave unexpectedly. - Make the platform observable, reliable, and auditable so submissions can be traced months later and clinics can run dozens of requests on busy mornings without breakage. - Make consequential architecture decisions independently, knowing those choices will shape both the product and patient access to care for years. - Translate real-world payer and clinic behavior into durable system improvements rather than one-off fixes.
Requirements
- Deep hands-on experience with FHIR-based APIs and an understanding of where they fall short in production. - Familiarity with X12 278 transactions and the healthcare payer integration landscape. - Comfort operating as a founding engineer with full ownership of architecture decisions and no platform team to defer to. - Ability to build for reliability and auditability, not just a working first version. - Direct, honest communication style and willingness to commit to an early-stage, pre-revenue environment.
Nice to have
- Prior experience shipping integrations that handle messy real-world edge cases from multiple live payer or EHR systems.
Benefits and work setup
- Remote role with required overlap with US business hours. - Founding-level compensation package including meaningful equity alongside a fair base salary, with specifics discussed directly during the process.