Founding Engineer

Founding Engineer

Job title: Founding Engineer

Location: San Francisco, CA (in-person only, relocation available)

About the Company

They help speech, occupational, and physical therapists build their own private practices. Their AI-powered “business-in-a-box” handles everything from business setup and insurance to marketing and software, so therapists can focus on what they do best: helping children.

They are a small team in San Francisco backed by industry-leading investors who share their vision to reimagine the shape of pediatric care in the US. If you’re ready to build something big, you’re in the right place.

Role Overview

They are hiring our Founding Engineer (Full-Stack) to work in-person, 5 days/week, in San Francisco as a member of the founding team. The office is currently in Mission.

This is not a 9-to-5 role. This is a chance to join an early-stage startup, work incredibly hard to build something massive, and get unmatched career growth and learning along the way. What they are building matters - to families, to therapists, and to the kids waiting for care.

You’ll be an equal thought partner in product and engineering - making foundational decisions on the stack, infrastructure, and development practices. You’ll work directly with co-founders to bring the AI-powered software to life and evolve it into a scalable, secure, and delightful platform used by real clinicians and families.

This role is ideal for an engineer who wants to build from zero, shape culture and architecture, and leave a tangible mark on an early healthcare startup.

What You’ll Do

• Lead end-to-end development of the core web applications - from architecture to deployment
• Design and implement AI-powered product features
• Collaborate on product and technical design, shaping how the systems, APIs, and data models evolve
• Build and ship features rapidly while maintaining strong engineering quality (testing, observability, CI/CD)
• Establish early engineering processes, infrastructure standards, and documentation
• Own technical decisions around scalability, security, and maintainability - especially given HIPAA-compliant requirements
• Contribute to (and debate!) product direction, tradeoffs, and long-term technical vision
• Help define the early engineering culture and assist with future technical hires

Our Technical Environment

They use TypeScript and React with modern tooling - but they expect our architecture to evolve. You’ll have major input into how the stack, process, and infrastructure are shaped as they scale.

You Might Be a Fit If You…

• Have 2+ years of professional experience building and scaling modern web applications
• Are fluent in TypeScript, React, and modern backend frameworks (Node.js, or similar)
• Have experience with Vercel/AWS and CI/CD pipelines
• Move fast - Proficient with AI coding tools like Cursor, Codex, etc.
• Have strong opinions on architecture, testing, and developer experience - but value pragmatism over perfection
• Are excited by early-stage ambiguity and want to build real systems, not just prototypes
• Thrive working in-person with a small team, iterating quickly on product and design
• Bonus:
  • Experience with healthcare, regulated environments, or automation workflows
  • Familiarity with FHIR standard and GraphQL APIs