Founding Head of Engineering

kadence; United States; Hybrid; USD 120,000 - 160,000; Full time

Job summary

A leading HealthTech startup based in San Francisco is looking for a Head of Engineering to join as a founding team member. In this role, you will design and build the core platform focusing on APIs and data models while also contributing to workflow automation using AI tools. The ideal candidate will have over 7 years of software engineering experience, strong full-stack skills, and a background in SaaS products. This opportunity involves significant ownership and shaping of the engineering culture.

Qualifications

• 7+ years of software engineering experience required.
• Strong full-stack skills and comfortable with backend-heavy tasks.
• Experience at a SaaS/product company is essential.

Responsibilities

• Design and build the core platform including APIs and UI.
• Implement claims workflow with human-in-the-loop support.
• Contribute to automation using LLMs and standard tools.

Skills

Full-stack development

Experience with LLMs/AI features

SaaS/product company experience

Strong coding abilities

Curiosity and enthusiasm for AI tooling

Job description

VC Funded HealthTech · San Francisco (preferred) / Remote · Full-time · Founding Team

Our client is building an AI-powered decision engine for healthcare billing disputes, automating the arbitration process between hospitals/doctors and insurance companies. We’re backed by a well known Venture Studio (with a successful track record) and are partnered with a law firm providing ~$400M of claims as both training data and initial revenue, plus early provider/hospital network partners.

Role

We’re hiring our first engineer (de-facto Head of Engineering) as a founding team member. You’ll own the end-to-end build of our initial platform and help shape the technical direction and engineering culture.

What You’ll Do

• Design and build the core platform: APIs, data models, workflow/state machine, and UI
• Implement a claims workflow supporting human-in-the-loop operations
• Gradually automate manual steps using LLMs and standard automation tools
• Contribute to the decision engine that selects which claims to contest, how, and for how much
• Establish engineering best practices (testing, monitoring, security)
• Partner closely with the founder on product decisions and future hiring

What We’re Looking For

• 7+ years software engineering experience, including:
• Strong full-stack skills (backend-heavy, competent frontend)
• Experience at a SaaS/product company
• Startup or zero-to-one experience (early-stage, high ambiguity)
• Solid grounding in:
• Workflow/state machines, queues, or operations-heavy systems
• 1–2+ years working with LLMs/AI features in a product (agentic or workflow automation a plus)
• Hands-on: comfortable shipping code ~50%+ of your time while owning architecture
• Bias toward startup pace and ownership over large, process-heavy environments
• Curiosity and enthusiasm for rapidly evolving AI tooling

Nice to Have

• Experience in healthcare, insurance, or regulated environments