Director of Engineering

Trellis AI; San Francisco (CA); On-site; USD 240,000 - 360,000; Full time

Benefits offered by this job

Medical coverage

PTO & Sick Time

Daily meals

Team offsites

Job summary

Trellis AI is building self-improving agents to accelerate access to life-saving medicine. As Director of Engineering, you will shape the engineering bar, hire and mentor a growing team, and drive fast-but-safe shipping across platform, deployments, and product pods.

You'll work closely with the founders and CTO to align on architecture, scalability, and delivery to healthcare providers across the U.S. You will balance speed with reliability while expanding the team and capabilities in a

Qualifications

• Led engineering at a fast-growing, early-stage startup (seed to Series B).
• Proven ability to hire, grow, and develop engineers at scale.
• Deep technical credibility with senior engineers and architecture work.
• Set engineering practices to boost speed and quality.
• Experience with distributed systems, cloud infra, or AI/agentic products is a plus.
• Healthcare domain experience is a plus.
• High ownership, strong communication, and comfort with ambiguity.

Responsibilities

• Scale the team by hiring, onboarding, and growing engineers and engineering managers.
• Define and enforce engineering practices including environments, testing, code review, and delivery cadence.
• Make big technical calls on architecture, vendor selections, and platform integrations (TypeScript, AWS, Temporal).
• Ensure reliability as the system scales beyond current scale expectations.
• Unblock engineers and align platform, deployed, and product teams on priorities.
• Collaborate with founders, deployments, and GTM to translate customer needs into a roadmap.

Skills

Team leadership

Technical depth

Hiring & development

Engineering practices

Distributed systems / cloud / AI

Healthcare domain experience

Clear communication

Tools

TypeScript

AWS

Temporal

Job description

TRELLIS BUILDS AND DEPLOYS SELF-IMPROVING AGENTS TO GET PATIENTS ACCESS TO LIFE-SAVING MEDICINE.

Our AI agents process billions of dollars worth of therapies annually with patients in all fifty states. We do this by automating document intake, prior authorizations, and appeals at scale to streamline operations and accelerate care. We classify medical referrals, understand chart notes, and automate contract and reimbursement search to provide patients with accurate coverage determinations and cost responsibility. Think of us as the infrastructure behind how patients get their medications.

Trellis is a spinout from Stanford AI Lab and is backed by leading investors including YC, General Catalyst, Telesoft Partners, and executives at Google and Salesforce.

THE ROLE

We went from 6 to 8 figures of revenue in less than a year. Engineering is 15 people today in three pods (platform, deployed, and product), and we want to double the team by the end of the year. We're hiring a Director of Engineering to lead that growth and help us scale from here.

The question we're hiring against: what would someone who has taken a company from zero to nine figures in two or three years want to change here? You'll set the engineering bar, make the high-leverage technical and organizational calls, and build a team that ships fast without breaking the things patients depend on. You'll report to Jacky (Co-founder & CTO).

WHAT YOU'LL DO

• Scale the team: Hire, onboard, and grow engineers and engineering managers as we double headcount, and set the bar for who we hire

• Set how we build: Own engineering practices, including dev environments, testing, code review, and how we ship, so the team gets faster as it grows

• Make the big technical calls: Drive architecture and vendor decisions across our agent platform, Windows session fleet, and integrations (TypeScript, AWS, Temporal)

• Keep the system reliable: Make sure our infrastructure scales past the $10B of therapies we process today

• Unblock the team: Remove what slows engineers down, and keep platform, deployed, and product pods aligned on what matters most

• Partner across the company: Work with the founders, deployments, and GTM to turn customer needs into a roadmap the team can deliver

ABOUT YOU

You're early in a steep career curve: you've grown fast because you're very good, not because you've waited your turn. You've led engineering at an early-stage company that moved quickly, and you still like being close to the code. You want to build the team and the culture, not inherit a process.

WHAT YOU'LL BRING

• Experience leading engineering teams at a fast-growing early-stage startup (seed to Series B), ideally through a period of rapid headcount growth

• A strong technical background and credibility with senior engineers; you can still go deep on architecture

• A track record of hiring and developing great engineers

• Experience setting engineering practices that increased speed and quality

• Experience with distributed systems, cloud infrastructure, or AI/agentic products is a plus

• Healthcare experience is a plus

• High ownership, clear communication, and comfort with ambiguity

WHY WORK WITH US

• Real impact at massive scale: We serve patients in all fifty states and are scaling to hundreds of healthcare locations. When the team ships, thousands of patients feel it the next day.

• Incredible growth and traction: We've grown revenue 10x in the past few months alone.

• Work with the founding team: Partner directly with founders and F500 customers, alongside healthcare operations leaders who have overseen 50+ locations.

• Be at the forefront of AI in healthcare: Work on production-grade agentic systems that make critical healthcare decisions, not a demo.

• World-class team: Join teammates who have won international physics olympiads, published economics research, were founding engineers at unicorn startups, and taught AI classes to hundreds of Stanford graduate students.

Compensation & Benefits

The salary range above is our good-faith estimate. Your final level and base salary will reflect what you bring: your skills, your experience, and how much ownership you’re ready to take on. Base pay is only one part of the package. Every full-time teammate also gets meaningful equity, because the people building Trellis should share in what it becomes. We are committed to keeping you healthy and supported so you can do the best work of your career. Here are some of the benefits & perks we offer:

• Comprehensive medical, dental, and vision coverage

• Flexible PTO & Sick Time

• Daily meals in the office

• Team offsites

Equal Opportunity at Trellis

At Trellis, we’re building AI agents that help patients get life-saving medicine faster. The patients and providers we serve come from every background, and our team should too. Trellis is an Equal Opportunity Employer. We hire based on talent, curiosity, and drive, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.

If you need an accommodation at any point in our hiring process, let your recruiter know and we’ll take care of it.