Founding Engineer

Job title: Founding Engineer

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

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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.

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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.

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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

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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.

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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