Staff Software Engineer

About Foundation Health

Foundation Health is an AI operating system for pharmacy - built by a team who lived the problem firsthand, not one that came to healthcare from the outside. Every day, prior authorizations delay prescriptions, pharmacists lose hours to paperwork instead of patients, and prescriptions slip through the cracks between health systems. We believe thoughtfully applied AI can finally change that - deep, integrated infrastructure that streamlines how care is coordinated, purpose-built for the complexity of specialty pharmacy.

We're building toward a world where pharmacy teams spend their time on patients, not paperwork - where AI handles the routine so clinicians can focus on what only humans can do. Getting there takes the right people. We're looking for curious, ambitious folks who want to help solve healthcare's hardest problems - for our patients, our partners, and each other.

The Role

This isn't a pitch deck. Our platform is live in production inside major US health systems — including Intermountain Health — where our AI handles real patient communication over voice and SMS and plugs directly into Epic workflows. We have a public partnership with Amazon Pharmacy. We raised a $20M Series A led by Define Ventures. Our CEO is a 2x founder; our VP of Engineering came from DeepMind. We're ~70 people, past PMF, with enterprise customers pulling us forward faster than we can hire.

We're building out our engineering hub in Orlando, and we want a Staff Engineer who's genuinely excited about owning something — not just contributing to it. You'll be the technical anchor for one of our core products, making architectural calls that matter six months from now, not just this sprint. This is a hands-on role. You'll write code, not just review it.

Maybe you're somewhere big, where the systems are impressive but the ownership is glacial. Maybe you're at a startup that's stopped being one. Either way, the itch is the same — and here, the loop is: see the problem, build it, watch a pharmacist use it that week.

The technical problems you'd own

• Production agentic systems in a regulated environment — automated workflows, LLM-assisted QA, and AI features (RAG, function calling, evals) where the output touches real patient care, so the evaluation bar is genuinely high

• Multi-component system design across a product domain: Epic integration, prior auth pipelines, patient communication infrastructure

• The technical bar itself — through your own code as much as your decisions. Your PRs should be the ones people learn from

• Delivery across a workstream: cross-team dependencies, roadmaps tied to product milestones, and accountability for shipping software that solves the user's problem, not just software that passes tests

What we're looking for

• A track record of building complex systems from scratch — and being able to talk about the specific decisions you made and why

• High agency. You don't wait for a perfectly scoped ticket. You figure out what needs to happen and do it

• Comfortable in ambiguity. We're Series A — things move fast and change often

• Already using AI tools daily (we're Claude/Cursor-native across the team) and hungry to push that further

The stack is Node/TypeScript/GCP. No legacy code — greenfield all the way. We're not precious about it either; good engineers pick up new languages quickly.

The practical stuff

We're remote-first across the US, though we've just opened a hub in Orlando if you ever wanted your comp to survive contact with your cost of living. And it's early enough that the equity is founding-role equity, not a rounding error.