Principal Software Engineer

About Foundation Health

Foundation Health is transforming healthcare through an AI-powered digital pharmacy platform that seamlessly connects operational infrastructure with high quality patient experiences. Our mission is to transform patient centric care by connecting fragmented infrastructure, optimizing care coordination, and removing friction from the patient journey. We refuse to adhere to the status quo; instead, we actively pioneer solutions that will shape the healthcare practices of tomorrow.

This ambitious vision is only achievable with the dedication of the right team propelling us forward. We firmly believe that a supportive and inspiring work environment fuels creativity, transforming it into groundbreaking innovation. It is this very innovation that not only benefits our organization but also positively impacts our people, partners, and most importantly, our patients.

At Foundation Health, we foster a culture that encourages our team members to broaden their horizons, urging them to bring their passion and curiosity to the workplace each day. We understand that diverse perspectives fuel progress, and we actively seek individuals who share our commitment to excellence and forward-thinking.

The Mission: Fixing Healthcare with Code

Healthcare is plagued by fragmented, antiquated workflows that have remained stagnant for decades. We believe thoughtfully applied AI can finally bridge these gaps, enhancing both the provider's efficiency and the patient's care.

Specifically, we are revolutionizing the pharmacy space. We aren't building "chatbots" - we are building deep, integrated AI infrastructure.

As a Principal Software Engineer, you won't just write code; you will shape the multi-quarter engineering strategy and technical standards that make this mission possible.

The Role: Impact & Influence

This is a high-agency leadership position designed for an experienced builder who can operate across the entire stack while influencing the company's long-term technical trajectory. There are no pure managers at Foundation Health - we rely on technical leaders to guide our high-level engineering strategy.

Technical Strategy & Architecture

• System Design: Own the architecture across multiple product areas or the entire platform, designing systems capable of supporting 10-100x growth without major rewrites.

• Engineering Standards: Establish architectural patterns and technical standards adopted org-wide.

• Problem Solving: Identify and resolve root-cause quality failures or misalignments between system architecture and business direction.

• Technical Judgment: Drive build-vs-buy analyses and advise leadership on technical risks regarding product and Go-To-Market (GTM) strategy.

AI Adoption & Leverage

• AI Strategy: Define the AI tooling strategy for the engineering organization.

• Product Capabilities: Oversee the architecture of AI-powered product capabilities, including voice agents and AI-assisted clinical workflows.

• Technical Depth: Manage model selection, context window management, latency/cost tradeoffs, and evaluation methodologies.

• Safety & Standards: Take responsibility for AI quality and safety standards within the product.

Execution & Product Partnership

• Multi-Quarter Initiatives: Drive cross-team initiatives where success is measured by product outcomes (feature adoption, error rates) rather than just ticket throughput.

• Roadmap Shaping: Partner with product leadership to define the roadmap based on what is feasible, high-leverage, and risky.

• Product Health: Accountable for product health metrics and "definitions of done" that include actual product outcomes.

Leadership & Culture

• Mentorship: Grow Senior and Tech Lead-level engineers and develop the next generation of technical leaders.

• Org Growth: Own performance, leveling decisions, and technical recruitment strategy.

• Communication: Influence org-wide decisions through writing and advocacy, building consensus across teams with competing priorities.

The Team: AI-Native by Design

• We are led by a technical team with deep roots in high-scale engineering. We foster an "AI-native" culture where using the latest tools to automate the mundane and maximize output is not just allowed - it’s championed.

• Our Stack: Modern Node/TS/GCP.

• The Playground: Hands-on work with OpenAI, Langfuse, and Vertex AI to ship features into production environments that impact real patient care.

• Minimal Legacy Debt: You won’t be mired in 10-year-old bugs; you’ll be building the future.

What We’re Looking For

• The Builder Mindset: You have a track record of building products from scratch and can deep-dive into any part of the stack.

• Engineering Judgment: You know when to move fast and when to slow down, framing technical decisions in terms of business outcomes.

• AI Fluency: You have experience building AI products and use AI tools to maximize your own workload.

• High Agency: You don’t wait for a perfect Jira ticket; you figure out how to move the needle and do it.

• US-Based: You must currently be based in the US. We offer relocation assistance to our Orlando hub.

Location & Benefits

• Hybrid Orlando Hub: We believe in the power of getting together to whiteboard and "jam" on ideas. While we are a distributed team, we want engineers excited to head into our new Orlando hub when needed.

• Significant Equity: As an early hire in this window, you will take a meaningful stake in the company we are building.

• High Influence: You will have a direct seat at the table to influence both the product roadmap and the company's technical direction.

Ready to build the future of healthcare? Let’s talk.