Founding Lead Engineer

Axo Ventures; Sugar Land, Northern (TX, KY); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health insurance

Equipment provided

Retirement plan

Flexible schedule

Job summary

Axo Ventures is building an ambient, protocol-driven healthcare software platform for Orthotics & Prosthetics. We are seeking a Hands-On Engineering Lead to partner directly with our co-founders to write production code, set technical standards, lead daily execution, and lay the foundation to scale the team.

This is the highest-leverage engineering role, operating in a hybrid model in the Sugar Land/Houston area, with equity and comprehensive benefits.

Qualifications

• Hands-on leadership with ability to write production-grade code and mentor teams.
• Strong focus on domain-driven design, typing, and clean boundaries.
• Obsessed with user simplicity and delivery speed, with safety in mind.

Responsibilities

• Drive Execution: ship production-ready features end-to-end from ambiguity.
• Lead by Example: conduct code reviews, mentor hires, set standards.
• Make Core System Calls: own architecture decisions for clinics on the platform.
• Work in a Tight Feedback Loop: collaborate with clinical co-founder and providers.

Skills

Hands-on leadership

Domain-driven design

UI/UX focus

Code reviews

Tools

C# / .NET

gRPC

TypeScript

PostgreSQL

Job description

Most healthcare software is where a clinician's time goes to die. We're building the ambient tech stack that gives it back.

Clinics are already using our software today to save hours of daily charting and automate tedious admin workflows. At Axo, we are building the "Un-EHR," an ambient, action-oriented clinical software that makes administrative work invisible so providers can focus 100% of their attention on human care.

Our entry market is Orthotics & Prosthetics (O&P), the field designing braces and artificial limbs that restore human mobility. Tech never showed up for them; we are. Beyond our core business, we participate in humanitarian missions to expand prosthetic access in critical parts of the world like Ukraine and Sri Lanka.

We are looking for a Hands-On Engineering Lead to partner directly with our co-founders (ex-Google SWE and a nationally recognized O&P clinician). This is the highest-leverage engineering role in the company: you will write production code, set technical standards, lead daily execution, and lay the foundation to scale the team.

The Role

Drive Execution: Take ambiguous clinical and business problems and ship production-ready features end-to-end.

Lead by Example: Conduct rigorous code reviews, mentor current and future hires, and establish team testing/architectural standards.

Make Core System Calls: Own critical architecture decisions that hundreds of downstream clinics will run on.

Work in a Tight Feedback Loop: Collaborate directly with our clinical co-founder and practicing providers using the software daily.

What We Look For

Hands-on Leadership: Ability to write clean, high-velocity code and guide team execution, review PRs, and enforce engineering discipline.

Domain & Data Mindset: Deep focus on domain-driven design, clear typing, and clean boundaries over quick hacks.

Obsession with User Simplicity: A sharp UI/UX eye and a rule that loading spinners are engineering bugs, not design choices.

Tool Adaptability: We are tool-agnostic. Whether you leverage AI speed-coding or write everything by hand, we care about delivery, safety, and speed.

Current Tech Stack (for context, not required)

C# / .NET backend, contract-first gRPC API, SolidJS / TypeScript frontend, PostgreSQL, domain-driven architecture, and isolated AI agent pipelines.

Equity: Meaningful founding equity

Location: Hybrid in Sugar Land / Houston Area

Benefits: Health, equipment, retirement, and schedule flexibility