AI Engineer · Remote · US · AI Engineering $170,000–$270,000 4mo ago

Aimlroles; Northern (KY); Hybrid; USD 170,000 - 270,000; Full time

Benefits offered by this job

Fully remote

Competitive pay & equity

Comprehensive health coverage

Paid time off

401k plan + matching

Paid parental leave

Home office stipend

Job summary

Cadence, a clinical AI company, seeks an AI Engineer to design and ship production agents that synthesize real-time clinical data, surface proactive care recommendations, and act on behalf of clinicians.

You will shepherd AI-powered clinical workflows from prototype to production, covering retrieval, reasoning, tool use, evaluation, and safety guardrails, with a focus on reliability and scale.

Qualifications

• Bachelor's or Master's degree in Computer Science, Engineering or related field, or equivalent work experience.
• 2+ years building AI/ML-powered systems in production.
• Experience in a high-growth, fast-paced environment with end-to-end ownership from design through production.
• Hands-on experience with LLM APIs including prompt engineering, tool use / function calling, and structured outputs.
• Experience building RAG systems: embeddings, vector stores, retrieval optimization, and grounding.
• Experience with agent frameworks or orchestration patterns (tool calling, planners, multi-agent coordination) preferred.
• Fine-tuning experience (SFT, RLHF, LoRA) on domain-specific tasks preferred.
• Healthcare or regulated-industry experience (HIPAA, SOC 2, clinical data handling) preferred.

Responsibilities

• Design, build, and deploy clinical AI agents that reason over patient context, invoke tools, and generate care recommendations.
• Own reliability, observability, and cost efficiency of LLM-powered workflows at scale.
• Build and optimize RAG pipelines over clinical knowledge bases, treatment protocols, and real-time patient data.
• Develop evaluation frameworks: offline benchmarks, safety tests, regression suites, and LLM-as-judge pipelines wired into CI/CD.
• Design multi-step agent orchestration: planning, memory, tool use, error recovery, and human-in-the-loop escalation paths.
• Collaborate with clinical, product, and engineering teams to translate patient care needs into AI system design.
• Stay at the forefront of AI and engineering best practices, continuously pushing the team to raise the bar on quality, performance, and architecture.

Skills

AI/ML systems

LLM APIs

RAG systems

Agent frameworks

Fine-tuning

Healthcare experience

Education

Bachelor's or Master's in CS/Engineering or related field

Tools

OpenAI API

Anthropic API

Open-source LLMs

Embeddings/Vector stores

Job description

Cadence is the clinical AI company automating the treatment of chronic disease. Its Clinical Intelligence takes on the routine, high-volume work of chronic care – monitoring patients, surfacing risks, and coordinating action – so clinicians can focus on the decisions that require them. Grounded in partnerships with more than 20 leading health systems, deep EMR integrations, dedicated medical group, and experience serving a population of more than 100,000 patients, the system learns from real-world care delivery, improving as it scales. Cadence has been recognized by TIME as one of the Top 100 HealthTech Companies and by LinkedIn as a Top Startup (#4, 2025).

The Role

We're hiring an AI Engineer to design and ship production agents that synthesize real-time clinical data, surface proactive care recommendations, and take action on behalf of clinicians.

You will take agent architectures from prototype to production in a domain where reliability directly affects patient outcomes. You'll own the full lifecycle of AI-powered clinical workflows: retrieval, reasoning, tool use, evaluation, and safety guardrails. If you've built agentic systems at scale and want your work to matter beyond engagement metrics, we’d love to speak with you.

What You'll Do

• Design, build, and deploy clinical AI agents that reason over patient context, invoke tools, and generate care recommendations.
• Own reliability, observability, and cost efficiency of LLM-powered workflows at scale.
• Build and optimize RAG pipelines over clinical knowledge bases, treatment protocols, and real-time patient data.
• Develop evaluation frameworks: offline benchmarks, safety tests, regression suites, and LLM-as-judge pipelines wired into CI/CD.
• Design multi-step agent orchestration: planning, memory, tool use, error recovery, and human-in-the-loop escalation paths.
• Collaborate with clinical, product, and engineering teams to translate patient care needs into AI system design.
• Stay at the forefront of AI and engineering best practices, continuously pushing the team to raise the bar on quality, performance, and architecture.

What You Need

• Bachelor's or Master’s degree in Computer Science, Engineering or related field, or equivalent work experience
• 2+ years building AI/ML-powered systems in production
• Experience in a high-growth, fast-paced environment with end-to-end ownership from design through production
• Hands-on experience with LLM APIs (OpenAI, Anthropic, open-source models) including prompt engineering, tool use / function calling, and structured outputs
• Experience building RAG systems: embeddings, vector stores, retrieval optimization, and grounding
• Experience with agent frameworks or orchestration patterns (tool calling, planners, multi-agent coordination) preferred
• Fine-tuning experience (SFT, RLHF, LoRA) on domain-specific tasks preferred
• Healthcare or regulated-industry experience (HIPAA, SOC 2, clinical data handling) preferred

Compensation

Our job titles may span more than one career level. The base salary for this role typically ranges between $170,000 – 270,000 annual base salary, depending on experience, skills, seniority, and business needs. In addition to base salary, this role is eligible for equity as part of the total compensation package. Actual compensation may vary by location.

Benefits & Perks

• Competitive pay & equity*
• Fully remote
• Comprehensive health coverage: Medical, dental & vision
• Paid time off
• 401k plan + matching
• Paid parental leave
• Home office stipend

Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws.

A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team. Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence. If you require a reasonable accommodation during the interview or hiring process, please notify your recruiter.