Lead Founding Engineer

Axo Ventures; Houston (TX); Hybrid; USD 150,000 - 210,000; Full time

Benefits offered by this job

Equity

Hybrid in Sugar Land / Houston Area

Health, retirement, schedule flex

Job summary

Axo Ventures in Houston hybrid environment is hiring a Hands-On Engineering Lead to partner with the co-founders. You will write production code, set technical standards, and lead daily execution to scale the team.

You will drive architecture decisions for the core system and collaborate with clinicians who use the software daily, shaping an ambient EHR-like platform for orthotics and prosthetics. Ideal candidates bring strong leadership, domain-driven design experience, and a passion for

Qualifications

• Ability to write clean, high-velocity code and guide team execution.
• Experience with domain-driven design, typing discipline, and clean boundaries.
• Focus on user simplicity and avoiding loading spinners as design choices.
• Comfort with a tool-agnostic, delivery-focused environment.

Responsibilities

• Drive Execution: ship production-ready features end-to-end.
• Lead by Example: conduct code reviews, mentor hires, establish standards.
• Make Core System Calls: own architecture decisions for clinics.
• Work in a Tight Feedback Loop: collaborate with co-founders and clinicians.

Skills

Leadership

Domain-Driven Design

UI/UX Mindset

Tool Adaptability

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