Go-to-Market (GTM) Systems Architect (backed by Y Combinator, $5M+ ARR, $23M+ raised)

About Legion Health

At Legion Health, we believe everyone deserves fast, affordable, and world-class health care, and we’re developing the AI infrastructure to deliver it ourselves at world scale.

Legion is building autonomous medical care (the AI doctor), starting with psychiatry. Our AI-native care-delivery platform currently automates 95% of the administrative work required for us to deliver direct patient care. We also recently became the first company ever to receive regulatory authorization to let AI prescribe psychiatric medications, allowing us to not only collapse health care’s admin costs but also its clinical labor costs-shifting this industry’s economics from humans to tokens.

Our technical moat is hard to copy-we combine rich data, production AI, doctors in the loop, and end-to-end care operations to deliver measurably better care to a clinically complex patient population. This has helped us produce tens of thousands of total visits in just 2 years, all while holding ops costs flat and achieving industry-leading patient NPS and retention. While the last generation of healthcare startups made the existing system incrementally more efficient, Legion is rebuilding full-stack care delivery from first principles. Our vision? A 10X better patient experience that’s higher quality, less expensive, and more scalable than ever before. And a 10X better clinician experience that frees our providers to focus on what matters most: caring for patients.

Legion Health is backed by Y Combinator, leading venture capital firms, and founders from Function Health, Modern Health, Everly Health, Trusted Health, Clipboard Health, PatientPing, Sesame Care, Faire, EasyPost, and fuboTV.

Join us as we build the future of health care: faster, higher-quality, and more affordable, powered by doctors and AI working together.

Role Logistics

• Job Type: Full-Time

• Role Type: GTM Engineering / Revenue Systems / Provider Partnerships / AI Automation / Data & Attribution

• Ideal Experience Level: 5+ years, including 3+ years owning GTM systems, revenue automation, growth engineering, or technical RevOps

• Location: In-Person in San Francisco, CA

• US Visa Sponsorship: Yes

The Opportunity

Legion is hiring a Founding GTM Engineer to build the AI-native commercial and referral infrastructure behind our provider-partnership motion. Your systems will help us identify the right provider organizations, reach the right stakeholders, turn interest into referrals, and move referred patients into care quickly.

This is not a traditional RevOps or CRM administration job. You will own the technical architecture from market mapping and outbound through referral intake, attribution, eligibility, onboarding, and partner reporting. You will configure best-in-class tools when they are sufficient and write code or build integrations, agents, and internal products when they are not.

You will build both sides of our sales motion. From the bottom up, Legion needs a complete view of every clinic, location, physician, referral coordinator, and office leader in a market. From the top down, we need to map enterprise medical groups, centralized referral teams, executives, clinical leaders, and every stakeholder who can shape a partnership. The system should tell each representative who matters, why they matter, what happened last, and what to do next.

You will also engineer the path from referral to care. Referrals may arrive through fax, forms, APIs, tracked links, QR codes, phone calls, or patients who begin online after a provider recommendation. Regardless of channel, Legion must identify the source, resolve the provider and organization, preserve attribution, process the referral, initiate eligibility and onboarding, and synchronize the right data across our CRM, product, analytics, and patient-engagement systems.

The right person is a hands-on systems builder with strong product judgment. You should be comfortable choosing a CRM, modeling complex account hierarchies, writing SQL and lightweight production code, integrating APIs, deploying AI workflows, debugging failures, and partnering with sales, product, engineering, data, operations, clinical, compliance, and security teams. Over time, you will help turn provider partnerships into a secure product that makes Legion the easiest specialty care partner in the country: simple to refer patients to, easy to collaborate with, and consistently responsive.

Responsibilities and Deliverables

• Select and architect Legion’s provider-partnership CRM-whether HubSpot, Salesforce, Attio, or another AI-native platform-as the source of truth for organizations, locations, stakeholders, opportunities, referrals, ownership, and next actions.

• Design a durable account hierarchy that connects individual clinicians, clinic locations, care teams, medical groups, parent organizations, enterprise partnerships, and internal owners without losing history or context.

• Build a provider prospecting data layer using NPI and claims data, Definitive Healthcare or similar datasets, public sources, enrichment providers, and Legion’s internal data.

• Create account-scoring and territory systems that prioritize targets using geography, specialty, patient volume, payer mix, referral potential, network relationships, and engagement signals.

• Build coordinated outbound workflows across email, phone, LinkedIn, direct mail, events, lunch-and-learns, and field sales using tools such as Clay, Apollo, LinkedIn Sales Navigator, sequencing platforms, AI agents, and custom integrations.

• Map clinic-level champions and referral coordinators alongside enterprise executives, clinical leaders, operations leaders, and centralized referral teams so Legion can sell from the bottom up and the top down.

• Equip sales representatives with accurate contact data, office addresses, account briefs, relationship history, meeting preparation, follow-up automation, and clear next-best actions.

• Deploy AI-assisted workflows for account research, stakeholder discovery, enrichment, outreach drafting, call intelligence, CRM updates, and follow-up with appropriate evaluations and human review.

• Build an omnichannel referral-ingestion layer that turns fax, forms, APIs, tracked links, QR codes, phone calls, provider handoffs, and patients who begin online after a provider recommendation into structured, traceable records.

• Automate referral processing, including document extraction, provider and organization matching, deduplication, completeness checks, routing, exception handling, and audit trails.

• Connect referral intake to insurance eligibility and AI-native front-desk workflows for patient outreach, onboarding, and scheduling so referred patients reach the right next step without avoidable delays.

• Own end-to-end attribution across the referring clinician, clinic, parent organization, partnership, sales representative, campaign, channel, UTM, QR code, landing page, fax source, and downstream patient journey.

• Integrate the provider CRM, Legion’s database, the patient-facing CRM, PostHog, Braze or another lifecycle platform, analytics systems, and custom applications into one coherent data flow.

• Partner with product and engineering to build secure provider-facing dashboards and workflows for referral volume, referral status, time-to-contact, scheduling progress, coverage and copay information, and other authorized care-coordination information.

• Build compliant workflows that return medical records, care summaries, and status updates to referring care teams through approved fax, secure email, portal, interoperability, or other authorized channels at the right cadence.

• Create dashboards and operating reviews for market coverage, stakeholder penetration, outreach performance, pipeline, referral volume, conversion, speed to care, repeat referrals, partner expansion, and revenue impact.

• Own production reliability across monitoring, logging, retries, rate-limit handling, identity resolution, testing, versioning, access control, documentation, and recovery when systems fail.

• Treat HIPAA, PHI handling, minimum-necessary access, role-based permissions, audit trails, consent, and provider trust as product requirements in every automated workflow.

• Make disciplined build-versus-buy decisions, ship useful first versions quickly, and drive adoption through clear playbooks, training, and change management.

You’ll Be Successful If You…

• Give Legion a provider CRM and data model that the team trusts as the source of truth.

• Create a complete, prioritized map of each market so representatives spend time with the right organizations and people.

• Build a repeatable outbound engine that produces qualified provider conversations and pipeline through coordinated digital, field, bottom-up, and top-down plays.

• Ensure every referral is captured, processed, routed, and attributed correctly regardless of how it arrives.

• Reduce the time from referral to eligibility, patient contact, onboarding, scheduling, and completed care.

• Give referring care teams a secure, useful experience that increases trust and repeat referrals.

• Remove repetitive research, data entry, document processing, routing, follow-up, and reporting work without sacrificing accuracy or judgment.

• Build reliable systems that sales and operations adopt, improve continuously, and measurably increase referral volume, conversion, speed to care, partner retention, and revenue.

Ideal Background and Skills

• 5+ years in GTM engineering, revenue operations, sales operations, growth engineering, business systems, data engineering, internal tools, or another systems-building role close to revenue.

• 3+ years directly owning CRM architecture, GTM automation, data pipelines, outbound infrastructure, attribution, or technically complex revenue programs.

• Strong technical foundation: advanced SQL plus the ability to write and review production-quality Python, JavaScript, or TypeScript for integrations, automations, and internal tools.

• Deep CRM fluency in HubSpot, Salesforce, Attio, or similar, including objects, associations, account hierarchies, lifecycle stages, permissions, routing, reporting, deduplication, and data governance.

• Hands-on experience with APIs, webhooks, ETL or reverse ETL, event instrumentation, identity resolution, error handling, observability, and modern data warehouses.

• Practical fluency with modern GTM tools such as Clay, Apollo, Definitive Healthcare, LinkedIn Sales Navigator, Outreach, Salesloft, n8n, Make, Zapier, Workato, or equivalent platforms.

• Production experience with LLM-powered research, extraction, classification, routing, or agentic automation, including structured outputs, evaluations, monitoring, confidence thresholds, and human-in-the-loop review.

• Strong analytical judgment across funnels, attribution, pipeline, conversion, velocity, cohort analysis, experimentation, and revenue impact.

• Strong product sense and build-versus-buy judgment. You can turn a messy frontline problem into a coherent system that people trust and use.

• Strong preference for experience in healthcare, provider partnerships, referrals, physician networks, field sales, multi-location organizations, or another complex relationship-driven business.

• Healthcare and security judgment: disciplined access controls, auditability, minimum-necessary access and data use, consent, and close partnership with compliance and clinical leaders.

• Bonus: experience with eFax, referral management, EHR integrations, HL7, FHIR, eligibility, claims, provider directories, or NPI data.

• Excellent cross-functional communication. You can translate the needs of a sales representative, referral coordinator, operator, clinician, engineer, analyst, and executive into a system that works.

• Low ego, high ownership, and startup intensity. You can diagnose the bottleneck, design the solution, ship a useful version, measure the result, and improve it quickly.

Compensation & Benefits

• Salary: $140,000 - $260,000, based on experience

• Early-Stage Equity: Competitive

• Health Insurance: Medical, dental, and vision benefits

• Additional Perks: In-person retreats, meal stipends, GTM and revenue-systems tooling budget, learning stipend, AI tooling budget

• Time Off: Flexible, unlimited vacation policy

• Work Hours: Flexible, with responsiveness around high-impact launches or system issues

• Work Setup: In-Person in San Francisco, CA

• Impact: Build the technical system that turns partnerships into faster access to high-quality medical care for all.

• Autonomy and Learning: Own CRM architecture, provider data, outbound infrastructure, referral workflows, attribution, AI automation, reporting, and partner-facing systems end-to-end.

• Growth Opportunities: As Legion scales, this role can grow into Head of GTM Engineering, Head of Revenue Operations, or a broader product and growth leadership role.

How to Apply and Hiring Process

• Apply here: https://jobs.ashbyhq.com/legionhealth/3a007cb1-faad-4854-a847-e4b77eaf3a42

• Overview of our hiring process:

• Resume + Application Screen

• Founder Interview

• GTM + AI Systems Deep Dive

• Professional Reference Checks

• Estimated time-to-hire: 2 weeks

• Start date: ASAP

• Hiring manager: Arthur MacWaters

Equal Employment Opportunity

Legion Health is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees, contractors, and applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, genetic information, or any other protected characteristic under applicable law. We encourage applicants from all backgrounds to apply.