Principal Software Engineer
Foundation Health6 hours ago
Responsibilities
- Own architecture across several product areas and design systems that can scale 10–100x without a rewrite.
- Build and improve production voice and SMS AI agents, including evaluations, guardrails, red teaming, and pharmacist-oversight design.
- Develop deep Epic EHR integrations, prior authorization automation, and 340B compliance workflows.
- Define target-state architecture and build the initial migration path from a handful of health systems to hundreds.
- Make model-selection, context-management, cost, latency, and evaluation decisions for AI engineering.
- Mentor engineers, lead cross-team projects, and improve engineering practices including agentic development.
- Personally investigate and build first versions of the company’s hardest technical problems.
Requirements
- Recent hands-on experience building and shipping serious production systems.
- Experience operating at Staff+ level and making architectural decisions that remain in use across a company.
- Production experience with LLMs, including agents, tool use, evaluations, guardrails, and reliability work beyond SDK calls.
- Experience designing simple, pragmatic architectures and changing them in response to real constraints.
- Experience working in environments where mistakes are expensive, such as healthcare, fintech, fraud, trust and safety, or compliance-oriented domains.
- Ability to independently identify and solve high-leverage company problems.
- Experience with AI safety, LLM security, agentic development practices, or production healthcare systems is valuable.
Benefits
- Remote-first work arrangement across the US.
- Access to an engineering hub in downtown Orlando for occasional visits.
- Preference for Eastern or Central time zones to support overlap with the UK-based engineering team.
- Founding-role equity at an early-stage company.
Tech Stack
Categories
About Foundation Health
Foundation Health builds an AI operating system for pharmacy that embeds into EHR workflows (Epic and Cerner) to automate prior authorizations, refill reviews, specialty intake, patient communications, 340B compliance, and infusion workflows. It sells its platform to health system and specialty pharmacies as enterprise software to reduce administrative work and speed patient access. Founded in 2024 and headquartered in San Francisco, the company is privately held.