Founding Engineer

About the Role

We are seeking a Founding / Principal Engineer to help rebuild one of the most important systems in American healthcare - from the inside, with startup speed and enterprise scale behind it, focused on benefit management. This is a confidential, high-priority initiative backed by board and executive sponsorship, and this hire will be among the first engineers on the team: no legacy codebase to inherit, no ten-layer approval chain to build through - just a small group of people with real autonomy, moving fast on something that actually matters.

This is a true 0→1 build for a brand-new AI-native healthcare benefits/PBM platform, operating as a startup-style team inside a Fortune 10 company, with executive and board backing. We can't share all the details yet - the full picture comes as candidates move through the process - but the problem space is huge, the stakes are real, and getting the foundations right will shape how this business runs for the next decade.

Responsibilities

• Join a founding team of 2–3 engineers and personally define the technical architecture and direction for a brand-new healthcare benefits/PBM platform
• Own major architecture decisions end-to-end - distributed systems, APIs, data models, and cloud infrastructure - with no legacy system to work around
• Write the first production code and build the core systems from scratch
• Operate with high autonomy and a direct line to senior leadership, moving from idea to decision quickly
• Build systems designed to handle high-volume, high-stakes healthcare data
• Help shape the engineering culture and practices for the team, not just join an existing one
• Maintain strict confidentiality and discretion; this role involves NDAs beyond standard company agreements

Qualifications

Required

• Proven experience building a meaningful product or platform from scratch (0-to-1), at a startup, a Series A–D company, a smaller high-growth company, or an internal skunkworks/0-to-1 team
• Demonstrated personal ownership of architecture, distributed systems, APIs, data models, and cloud infrastructure
• Experience building and operating systems with high-volume and/or high-stakes data
• Strong CS/software engineering fundamentals
• Recent, modern engineering experience: distributed systems, cloud-native architecture, event-driven systems, data platforms, and/or AI-native products
• Proficiency in one or more of: Python, Go, Java, TypeScript
• Operating at a Staff, Senior Staff, Principal, Senior Principal, Distinguished, or Founding Engineer level - hands-on and comfortable making major architecture decisions with minimal oversight
• Comfort working in a confidential, high-discretion environment

Preferred

• Healthcare, PBM (pharmacy benefit management), or benefits administration experience
• Background in fintech, insurance, data infrastructure, or AI platform engineering considered for exceptional candidates without direct healthcare experience
• Degree from a top CS/engineering program (e.g., Carnegie Mellon, Stanford, Berkeley, MIT, UIUC, Georgia Tech, Cornell, Princeton, or similar)