Lead Software Engineer - Medical OS

Alt; New York (NY); On-site; USD 180,000 - 210,000; Full time

Job summary

Neko is redefining preventive care by delivering AI-first clinical software that supports check-in, scanning, and clinician conversations, backed by a longitudinal health record. We seek a leader in full-stack engineering to ship AI-enabled workflows, mentor engineers, and partner with clinicians to create impactful care products.

You will spend time in clinics, champion customer-driven development, and drive cross-functional delivery while aligning with regulatory and clinical needs.

Qualifications

• Full-stack delivery across frontend and backend with AI integration.
• Ability to explain trade-offs in architecture and design decisions.
• Track record of shipping customer-centric products through direct customer input.
• Experience embedding AI or automation in product workflows.
• Strong communication and mentorship abilities.

Responsibilities

• Ship AI-native clinical workflows end-to-end across the stack, with clinician as decision-maker.
• Build a clinician-in-the-loop flywheel to increase clinician time with members.
• Engage with clinicians and members in clinics and translate learnings into shipped product.

Skills

Full-stack engineering

Architectural concepts

Product-minded

AI-first workflows

Mentoring & communication

Job description

Mission

Neko is redefining what prevention means, from treating illness when it arrives, to sustaining health before it's ever at risk. Our mission: make data-driven, preventative care accessible to more people, before symptoms appear.

In a single, non-invasive visit under an hour, proprietary technology and direct clinical care combine to deliver personalised, actionable insights. It's a team that thinks in 10x, not 10%. Every role here plays a part in building a world where prevention is the norm, and where your work genuinely helps people live longer, healthier lives.

Role Purpose

The Medical OS team builds the software behind every Neko visit, from check-in through the scan to the doctor's conversation with the member. We are building it AI-first: an intelligent clinical platform that prepares personalised briefings, drafts documentation, and handles routine coordination, so clinicians spend their time where they matter most, on clinical judgment and with members. Underneath it all sits a longitudinal health record that gets richer with every scan, the foundation for care that's personal, proactive, and consistent as Neko scales (Member-first, always).

What You'll Deliver in the First 6-12 Months

• Ship AI-native clinical workflows end-to-end across the stack: personalised pre-briefs, drafted debriefs, and intelligent assessment tools, always with the clinician as the decision-maker (Chase 10X, Not 10%).

• Build the clinician-in-the-loop flywheel: clinician expertise teaches the system, the system gives clinicians more time with members, and every scan makes care more personal (Tech-enabled, human-centred).

• Make direct contact with clinicians and members your working pattern: spend time in clinics, understand the work first-hand, and turn what you learn into shipped product (Impact, not activity).

Minimum Qualifications

• Full-stack engineering with the depth to lead complex, cross-functional delivery end-to-end. We don’t mind candidates that are stronger on back-end or front-end, if they can demonstrate how effectively at closing the gap in the weaker stack they are, including with AI.

• Solid command of architectural concepts and the frameworks they use: able to explain and defend trade-offs rather than assembling AI output blindly.

• Product-minded and customer-driven: a track record of shipping well-rated products with excellent customer experience, and of deciding what to build by talking to customers. The ideal candidate doesn’t delegate deciding what to build: they are part of it.

• Demonstrable AI-first ways of working, beyond "I use Claude to write code": agentic tooling in the daily workflow and experience building AI or automation into the product itself.

• Strong communication is a must with the ability to mentor the engineers around them.

Preferred Qualifications

• Consumer (B2C) product experience with a slick user experience, or B2B/B2B2C experience on a modern, well-rated product.

• Med-tech, clinical, or healthcare experience is a bonus. Experience in regulated industries (e.g. fintech) is equivalent: we value candidates already used to thinking about regulatory constraints.

• Exposure to hardware/firmware integrations or device ecosystems.