Cadence is the clinical AI company automating the treatment of chronic disease. Its Clinical Intelligence takes on the routine, high-volume work of chronic care – monitoring patients, surfacing risks, and coordinating action – so clinicians can focus on the decisions that require them. Grounded in partnerships with more than 20 leading health systems, deep EMR integrations, dedicated medical group, and experience serving a population of more than 100,000 patients, the system learns from real-world care delivery, improving as it scales. Cadence has been recognized by TIME as one of the Top 100 HealthTech Companies and by LinkedIn as a Top Startup (#4, 2025).
We’re hiring a Senior IT Systems Engineer to build and operate the identity, endpoint, and SaaS infrastructure that supports Cadence’s clinical and operational teams. You’ll use code, APIs, and AI-powered automation to make our systems more secure, reliable, and scalable as we grow.
This is a hands-on engineering role with ownership from design through deployment and ongoing operation. AI will be central to how you work, from accelerating development and troubleshooting to building intelligent workflows. You’ll turn manual processes and recurring problems into maintainable systems, partnering closely with IT Operations, Security, and teams across the business.
What You'll Do- Design, build, and own automation and API-driven integrations across Okta, Google Workspace, Slack, and other critical SaaS platforms to reduce manual work and improve reliability.
- Use AI-assisted development tools and LLM APIs to build and improve operational workflows, applying appropriate permissions, testing, monitoring, and human review.
- Build and scale identity lifecycle automation across employee onboarding, role changes, and offboarding, including provisioning, access controls, and timely deprovisioning. Partner with Revenue Operations on Salesforce access management, including permission sets and role-based access.
- Engineer automated device enrollment, configuration, software deployment, patching, and compliance workflows across our macOS and iOS fleet.
- Partner with Security to strengthen endpoint protections and secure access, automate security controls and evidence collection, and support audit readiness.
- Build reliable, maintainable systems through version control, code review, testing, and infrastructure as code, with clear documentation, monitoring, alerting, and recovery.
- Own complex technical projects and cross-system escalations from investigation through resolution, addressing root causes through automation and translating business needs into solutions that balance delivery speed, security, and reliability.
- 5+ years of experience in IT systems engineering, technical operations, or a related engineering role, with a track record of independently building and operating automation. Experience in a startup or high-growth environment is a plus.
- Practical experience using AI-assisted development tools as part of your engineering workflow and integrating LLM APIs into tools or automation. You can evaluate output quality, protect sensitive data, scope permissions, and determine when deterministic logic or human review is needed.
- Strong programming skills in Python, TypeScript, or a comparable language, with experience using Git-based development workflows and Terraform or similar infrastructure-as-code tools. Examples of tools, integrations, or open source projects you’ve built are welcome.
- Experience administering SaaS platforms such as Google Workspace, Slack, and Zoom and building REST API integrations, webhooks, and event-driven workflows using code, automation platforms such as Okta Workflows or Tines, or both.
- Strong knowledge of identity and access management, including hands-on experience with Okta, SAML, SCIM, OIDC, automated provisioning, and least-privilege access. Familiarity with Salesforce permission sets, permission set groups, and access controls is a plus.
- Hands-on experience managing macOS and iOS fleets through MDM platforms such as Kandji, Iru, or Jamf, including configuration, software deployment, patching, and device compliance. Experience with Netskope or Santa is a plus.
- Strong networking and security fundamentals, including DNS, TLS, VPNs, firewalls, Zero Trust access, and secure handling of credentials and sensitive data, with the ability to troubleshoot across systems independently. Experience supporting audit readiness for SOC 2, ISO 27001, HIPAA, or similar requirements is a plus.
Compensation
Our job titles may span more than one career level. The base salary for this role typically ranges between $175,000 – $200,000 depending on experience, skills, seniority, and business needs. In addition to base salary, this role may be eligible for equity as part of the total compensation package. Actual compensation may vary by location.
Benefits & Perks
- Competitive pay & equity*
- Fully remote
- Comprehensive health coverage: Medical, dental & vision
- Paid time off
- 401k plan + matching
- Paid parental leave
- Home office stipend
*benefit offerings may vary depending on job profile, job level and worker type
Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws.
A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team. Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.
If you require a reasonable accommodation during the interview or hiring process, please notify your recruiter.
Skills Required
- 5+ years of experience in IT systems engineering, technical operations, or a related engineering role
- Experience independently building and operating automation
- Practical experience using AI-assisted development tools
- Experience integrating LLM APIs into tools or automation
- Ability to evaluate AI output quality, protect sensitive data, scope permissions, and determine when deterministic logic or human review is needed
- Strong programming skills in Python, TypeScript, or a comparable language
- Experience with Git-based development workflows
- Experience with Terraform or similar infrastructure-as-code tools
- Experience administering Google Workspace, Slack, and Zoom
- Experience building REST API integrations, webhooks, and event-driven workflows
- Knowledge of identity and access management
- Hands-on experience with Okta, SAML, SCIM, OIDC, automated provisioning, and least-privilege access
- Hands-on experience managing macOS and iOS fleets through MDM platforms such as Kandji, Iru, or Jamf
- Experience with device configuration, software deployment, patching, and compliance
- Strong networking and security fundamentals, including DNS, TLS, VPNs, firewalls, and Zero Trust access
- Ability to troubleshoot across systems independently
- Experience in a startup or high-growth environment
- Experience with Salesforce permission sets, permission set groups, and access controls
- Experience with Netskope or Santa
- Experience supporting audit readiness for SOC 2, ISO 27001, HIPAA, or similar requirements
Cadence (cadence.care) Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Cadence (cadence.care) and has not been reviewed or approved by Cadence (cadence.care).
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Healthcare Strength — Health, dental, and vision coverage are complemented by mental health support and wellness programs. Offerings such as One Medical access, TalkSpace, and a 24/7 employee assistance program reinforce comprehensive care.
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Leave & Time Off Breadth — Time off includes unlimited vacation, paid holidays, and paid sick days. Parental leave is described as generous.
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Retirement Support — A 401(k) plan with company matching supports long-term savings. Additional tools like HSAs and FSAs bolster overall financial security.
Cadence (cadence.care) Insights
What We Do
Cadence is future-proofing primary care for an aging population. We’re building the first AI-native chronic disease platform – extending the doctor’s office beyond the visit and enabling health systems to deliver proactive care at home. Powered by our care intelligence and multidisciplinary clinical team, we monitor every patient, identify risks early, and act before problems escalate. Today, more than 90,000 seniors across 20 health systems rely on Cadence to stay healthier at home. Every day, more than 7,000 Americans age into Medicare, most with complex, ongoing health needs. Traditional healthcare was built for episodic visits, not for the continuous support that chronic care requires. The result? Overwhelmed health systems, rising costs, and patients who fall through the cracks. Cadence solves this problem. Our platform seamlessly integrates with a health system’s existing clinical workflow, using AI and machine learning to continuously monitor patient data, detect trends, and trigger timely interventions. We pair this technology with a nationally licensed clinical team that collaborates directly with each patient’s physician ensuring that every alert turns into meaningful, compassionate action. This hybrid model of technology + clinical care is what sets Cadence apart. We don’t just collect data; we turn insights into outcomes. Behind our platform is a world-class team of engineers, clinicians, and operators, all united by a shared mission — to make compassionate, continuous care accessible at scale. We tackle big, complex challenges with cutting-edge technology and deep empathy, knowing that every improvement we make has a direct impact on real people’s lives. Together, we’re building a system where technology amplifies humanity — and every patient gets the care they deserve, every day.
Why Work With Us
We’re a collaborative, learning-driven engineering culture tackling one of the toughest problems in tech - healthcare at scale. At Cadence, you’ll ship real-world systems that impact thousands of patients, gain exposure to cutting-edge AI and data science, and grow alongside teammates who value curiosity, humility, and excellence.
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