Full-Stack Engineer (Healthcare)

Clara is building the first AI-first medical practice from the ground up. Unlike most health AI startups, we deliver actual care: our clinicians write prescriptions, order labs and manage patients, supervised by human providers who review every medical decision. Clara's founders built and scaled Circle Medical to over $100M in revenue, and we are funded by Y Combinator and top investors.

This is a mission-driven, high-performance team working in person in San Francisco five days a week. We will assist with relocation and work visas for the right candidate.

What you'll build

You'll own product surfaces end to end: the patient app, the clinician-facing EHR, the API underneath them, and the seams where our LLM agent meets a real person. A typical month touches a React screen a patient sees, the Django endpoint behind it, the Celery job that follows up, the Amplitude event that tells us whether it worked, and the review queue a nurse practitioner uses to approve what the AI proposed. You'll write the code, ship it, wire the events, read the results and fix what they tell you.

Your responsibilities

Product engineering (60%)

• Ship features across the patient app, staff EHR, and backend (React + TypeScript front end, Django on PostgreSQL)
• Build the surfaces where the AI agent meets people: streaming chat, tool-call results, clinician review and approval flows
• Design onboarding that gets patients to first real value fast, then to habitual use
• Own the mobile shell (Capacitor, iOS and Android) alongside the web app
• Instrument what you ship (Amplitude) and read the results, so the next iteration is driven by what patients and clinicians actually did

Platform and integrations (40%)

• Own integrations with the services a medical practice runs on: Stripe, Twilio, medical-records APIs, Customer.io, identity verification
• Model clinical data in PostgreSQL so the product and the AI can reason over it
• Keep the system observable and safe: Sentry, Datadog, audit trails, HIPAA-conscious data handling
• Continuous integration and delivery; improve the developer loop (Tilt, mise, hk) as you go
• Build the internal tooling and background jobs that keep a medical practice running between patient visits

How we level this role

One posting, two seats. We decide the level from what you have shipped, not from the title on your last business card.

Level

Typical profile

What we expect on day one

Software Engineer

2+ years, has shipped React + TypeScript and a typed backend to real users

Ships well-scoped features end to end with review; learns the clinical domain fast

Senior Engineer

5+ years, has owned a product area in production

Owns a domain (EHR, onboarding, integrations) end to end; makes and defends architecture calls; early hires grow into engineering management as the team scales

Compensation tracks the level: $130K - $210K base · 0.10% 0.40% equity · health insurance and standard benefits.

What we're looking for

Required at every level:

• React + TypeScript in production, with users you can name
• A typed backend language in production; Python preferred, Django a plus
• Relational data modelling and SQL; you have designed a schema and lived with it
• You have shipped, owned the result, and can tell a story about something that broke and what you changed
• AI-native: you use Claude, Cursor or similar every day and can say what it is bad at
• Care about correctness and safety in a domain where mistakes reach patients

Additionally at Senior:

• Owned a product domain end to end, including the on-call and the roadmap
• Led a migration or re-architecture in a live system without breaking it for users
• Raised the bar for the engineers around you: reviews, patterns, mentoring

Nice to have:

• Healthcare or HIPAA experience; FHIR familiarity
• Django / Django Ninja, Celery, PostgreSQL JSONB
• Capacitor or native mobile
• Product analytics and experimentation (Amplitude or similar)
• LLMs as a production tool: content, creative, internal tooling, or building on top of an agent

What Clara offers

• Ship code that affects real patient health outcomes, and talk to real patients and providers regularly
• Make architectural decisions for an AI-first medical practice, working directly with the founders and CTO
• Ownership of entire domains (product, platform, integrations), and a path into engineering management as the team scales
• In-person collaboration in San Francisco, five days a week; no bureaucracy, ship fast

About the interview

• Intro call (30 min): meet the founding team, learn about Clara's mission
• Technical screen (60 min): a full-stack pairing problem, leveled to the seat
• Onsite (4 hours): system design, code pairing, team fit
• Reference checks and offer

• Intro call (30 min) - Meet founding team, learn about Clara's mission
• Technical screen (60 min) - Domain-specific challenge
• Onsite (4 hours) - System design, code pairing, team fit
• Reference checks + offer