Principal Software Engineer
Foundation HealthResponsibilities
- Own architecture across multiple product areas and design systems capable of supporting 10–100x growth without a rewrite.
- Remain a hands-on individual contributor who prototypes and builds the first version of the hardest technical solutions.
- Design safe agentic AI systems for voice and SMS interactions with real patients, including evaluations, guardrails, and pharmacist oversight.
- Lead deep EHR integrations involving Epic queues, prior authorization automation, and 340B compliance.
- Define the target-state platform architecture for expansion from a handful of health systems to hundreds and build the first migration mile.
- Drive AI engineering decisions involving model selection, context management, cost and latency tradeoffs, and evaluation methodology.
- Work directly with the VP of Engineering and CEO on high-leverage technical problems.
Requirements
- Deep, recent hands-on engineering experience building serious production systems.
- Experience operating at Staff+ level in a high-bar engineering organization.
- A record of architectural decisions that a company continues to rely on.
- Production experience building with LLMs and applied AI systems.
- Ability to work independently, identify the highest-leverage organizational problems, and solve them without being directed.
Benefits
- Remote-first work arrangement across the United States.
- Access to an Orlando hub for employees who want to use it.
- Founding-role equity at an early-stage company.
Categories
About Foundation Health
Foundation Health is the AI operating system for pharmacy. We help health system pharmacies do more with less by embedding AI directly into existing clinical workflows and EHRs, including Epic and Cerner, without disrupting how teams work today. Our platform automates and augments core pharmacy operations across: - Prior Authorizations – reduce manual work and accelerate approvals - Refill Authorizations – increase throughput with AI-assisted clinical review - MSOT & Intake Workflows – capture and route specialty prescriptions with precision - Patient Communications – automate outreach across SMS and voice - 340B Compliance & Revenue Recapture – identify ineligible claims, ensure compliance, and recover missed revenue - Infusion Workflow Management – automate end-to-end medical infusion workflows, from eligibility and prior authorization to site of care and scheduling, to accelerate time to treatment The result: less administrative burden, faster patient access, higher capture rates, and scalable growth—without adding headcount. Built on HIPAA-compliant, SOC 2-certified infrastructure. Reach out to discover how our AI operating system transforms pharmacy workflows.