About the Role
Join an early-stage healthtech team as its backend-leaning Founding Engineer. You will build and operate the core platform for real-time prescription pricing, claims processing, and payments, where reliability directly affects access to medication and financial transactions.
What You'll Do
Own backend APIs, database design, access controls, sensitive health data boundaries, backups, staging, observability, and deployments.
Build a real-time pricing system that gathers prices from multiple sources and routes claims to the lowest-cost option.
Manage eligibility and claims workflows connected to a claims adjudication system.
Develop an in-house claims adjudication engine and validate its results against a current system using replayed claims.
Build and operate payment infrastructure for transactions between business partners and pharmacies, targeting 99.99% uptime.
Make architecture and data model decisions that support growth from hundreds to tens of thousands of users.
What We're Looking For
Three to eight years of backend or full-stack engineering experience, with strong backend, architecture, and database schema design skills.
Experience building and operating production systems where errors or downtime have direct financial or operational consequences, such as payments, ledgers, trading, or critical infrastructure.
Proficiency with Python, FastAPI, PostgreSQL, row-level security, GCP, Cloud Run, Cloud SQL, React, and TypeScript.
Comfort using AI development tools such as Claude Code or Cursor.
Startup experience, ideally including operating as a sole engineer and making systems architecture decisions as a product scales.
Ability to communicate candidly and challenge technical decisions when needed.
Experience outside healthcare, health benefits, and pharmacy, plus a computer science or related degree, is a plus.
Must be able to work in person in New York and have work authorization that does not require employer visa sponsorship.
Compensation & Benefits
Base salary: $210,000 to $260,000 USD annually. Visa sponsorship is not available.
Location
On-site in New York, United States.
