Founding Principal Engineer
About the role
We're hiring our first senior engineer onshore: a Founding Principal Engineer who will sit beside the CEO and lead engineering. Until now, our engineering team has been offshore. We ship fast, but we've reached the point where we need a senior technical leader in the building to help accelerate our roadmap, make architectural calls as we scale, and lead the adoption of AI across the organization.
Key Responsibilities
Set the technical direction. Own architecture across telehealth, EHR, therapist onboarding, patient dashboard, and AI usage.
Help make the build/buy decisions. We do not build for the sake of building, and are thoughtful about what to outsource vs build.
Write the code that matters. Stay hands-on as a top individual contributor on the hardest, highest-stakes problems.
Lead the team. Direct and level up the offshore engineers, establish how we work (code review, testing, on-call, incident response), and bring rigor without bureaucracy.
Own reliability and security. Be accountable for the uptime and correctness of clinical systems, and for engineering practices that hold up to HIPAA and payor scrutiny.
Build the eng org. As we grow, hire onshore engineers, define how the team is structured, and set the culture and standards a larger team will inherit.
Define the stack. Currently use TypeScript across the stack, Node and React, deployed on AWS. You will help define the stack as we scale. We adopt new tech for leverage, not novelty.
Partner closely. Work directly with the CEO and translate clinical, growth, and operations needs into technical plans the team can execute.
Who You Are
You are energized about solving logistically complex problems
8+ years building production software, including time at the staff/principal level
You've been the most senior engineer in the room and owned systems end to end
Deep full-stack strength. You're comfortable owning everything from schema to UI
You've led while staying hands-on: set standards, mentored strong engineers, directed teams, and raised quality without stepping away from the code
You've worked with distributed or offshore teams, or have strong instincts for how to make that work
You've built in regulated, high-reliability, or data-sensitive environments (healthcare experience is a plus) and take security and correctness seriously
You're comfortable with ambiguity and limited resources, biased to ship, and energized by being the one who figures it out
You want to build in person
Success in this role means
Increase in engineering velocity
Acceleration of AI adoption across the organization
Architecture decisions are made deliberately and hold up as we scale
We can hire and onboard onshore engineers into a team with real standards and culture
Position details
Full-time
3 days/week in-person in NYC
The salary range is $200K – 240K, plus meaningful early-stage equity
You must be based in the United States and have U.S. work authorization