Lead Engineer, Voice AI

ModMed; United States; On-site; USD 120,000 - 190,000; Full time

Job summary

ModMed is hiring a dedicated telephony integration engineer to connect medical practices to our Voice AI platform. You will own end-to-end telephony integrations, secure call paths, and reliable routing across diverse cloud and on-premise systems.

You will build repeatable deployment playbooks, monitor quality metrics like post-dial delay and transfer success, and eventually grow a small team as our healthcare telephony footprint expands. Travel to enterprise installs may be required.

Qualifications

• 7+ years hands-on telephony engineering.
• Deep SIP knowledge; able to read traces and diagnose issues.
• PBX and SBC configuration and troubleshooting experience.
• Fluent with CPaaS APIs for number provisioning and routing.
• Comfortable with customers and explaining technical concepts.

Responsibilities

• Connect practices to the voice agent by configuring SIP trunks, call routing, and latency tuning.
• Work across cloud and on-premise phone systems (RingCentral, Vonage, Cisco, Avaya, Mitel, NEC).
• Preserve caller identity across forwards and logs.
• Secure call paths with TLS, SRTP, and access controls.
• Design fallback routing, health checks, and on-call runbooks.
• Transfer calls back to practice with context when needed.
• Monitor quality metrics and set up alerts; mentor others as the team grows.
• Travel to enterprise installations as required.

Skills

Telephony engineering

SIP knowledge

PBX and SBC experience

CPaaS APIs

Customer-facing

Builder mindset

Tools

AudioCodes SBC

Ribbon SBC

Cisco CUBE

Twilio

Telnyx

SignalWire

Job description

We are building a Voice AI agent for medical practices. It answers patient calls to schedule, reschedule, and cancel appointments, and to answer common questions. Our current voice partner is ElevenLabs.

You own the piece in between: the phone connection between a practice's existing phone system and the voice agent. Practices run everything from a cloud phone service to a ten-year-old on-premise PBX. You will get each one connected, secure, and reliable.

You are our first dedicated telephony hire. You will do the integrations yourself, write the playbook that makes them repeatable, and, as the customer base grows, hire and lead a small team.

What you will do

• Connect practices to the voice agent. Set up inbound and outbound SIP trunks, call forwarding, and number routing between practice phone systems and our voice partner. Tune transport settings for low latency and reliability.
• Work across a wide range of phone systems. Cloud services (RingCentral, Vonage, Zoom Phone, 8x8) and on-premise systems (Cisco, Avaya, Mitel, NEC), and the routing inside them: ring groups, auto-attendants, overflow rules, and after-hours schedules.
• Keep the caller's identity intact. Make sure the original caller number survives forwarding so calls are logged and matched correctly.
• Secure every call path. Use SIP over TLS and SRTP where the practice's equipment supports them, with IP allowlisting and digest authentication where it doesn't.
• Make sure no call is ever lost. If the voice agent, the trunk, or a transfer fails, the call goes to the practice's staff and never rings out. You will design and test the fallback routing, the health checks, and what a caller hears when something goes wrong.
• Hand calls to people. Transfer callers back to the practice (SIP REFER, warm or blind, depending on what the phone system allows) when a person is needed. Pass caller identity and context where the phone system supports it. Where it doesn't, work with the product team so the practice still gets a staff task.
• Monitor quality. Track post-dial delay, audio quality, concurrent-call limits, and transfer success. Set up alerts and own the on-call runbook.
• Build the playbook and the team. Document a repeatable deployment process by phone system type, define the architecture roadmap, and, as we grow, hire and mentor other telephony and integration engineers.
• Travel: You may need to travel to setup connection for enterprise customers

What you bring

• 7+ years of hands-on telephony engineering. Your background might be a contact center vendor (Five9, Genesys, Amazon Connect), a UCaaS provider (RingCentral, Zoom Phone), a CPaaS or carrier (Twilio, Telnyx, Bandwidth), or the telecom team of a hospital system or managed service provider. Experience in healthcare phone environments is a plus.
• Deep SIP knowledge. You can read a SIP trace and explain what went wrong.
• Real PBX and SBC experience. You have configured session border controllers (AudioCodes, Ribbon, Oracle, Cisco CUBE) and troubleshot legacy PBX routing, allowlists, and authentication.
• Fluent with CPaaS APIs. You are comfortable with Twilio, Telnyx, SignalWire, or similar for number provisioning, carrier routing, and SIP domains.
• Comfortable with customers. You can explain a technical problem to an office manager or a practice's phone vendor and get a clear answer back.
• A builder's mindset. You are happy to be an individual contributor on day one, and you have the judgment and communication skills to lead a team later.

Working with us

You will work with product, security, and the agent engineering team. You will not tune the agent's conversation behavior. You will make sure the call reaches it cleanly and gets back to a person when needed.