Member of Technical Staff

Lotus Health AI, Inc.; San Francisco, Northern (CA, KY); Hybrid; USD 180,000 - 260,000; Full time

Job summary

Lotus Health AI, Inc. is seeking an AI Engineer to help build and operate AI + data systems behind AI-driven primary care. You will work across model training, tooling, data pipelines, retrieval/evals, and product workflows, contributing from day one to product decisions and system design.

You’ll design data and retrieval systems powering clinical AI, improve correctness and explainability, and help shape real-time voice and video AI capabilities for empathetic patient interactions.

Qualifications

• Strong programming skills, preferably Python.
• Experience with data infrastructure, migrations, and simplifying complex systems.
• Familiarity with PostgreSQL (including JSONB) and AWS.
• Experience building production AI/ML workflows and tools.
• Hands-on with LLM APIs, prompt engineering, and shipping AI-powered features.

Responsibilities

• Design and iterate AI agent workflows enabling multi-step clinical reasoning and tool use.
• Build guardrails, fallback logic, and escalation paths for safe patient-facing AI.
• Prototype and ship end-to-end AI-powered features from model choice to UX.
• Improve knowledge bases and retrieval for fast, accurate clinical data citations.
• Rebuild data pipelines for data integrity, traceability, and real-time syncing.
• Develop real-time voice pipelines for patient interactions and multimodal AI models.
• Implement observability, monitoring, and analytics for AI systems in production.
• Fine-tune foundation models on clinical data to improve safety and tone.

Skills

Python

LLM APIs

Prompt engineering

Production debugging

Retrieval systems

PostgreSQL

AWS

Docker

FastAPI

Tools

SQLAlchemy

DuckDB

TensorFlow/PyTorch

Kubernetes

Job description

If you’re excited to rebuild healthcare, tell us why we should work together.

Lotus AI is a groundbreaking primary care app that integrates your medical records, AI, and real doctors to provide free, personalized healthcare and prescriptions.

Our team includes ex-founders and engineers who have built and scaled consumer apps to millions of users with prior successful exits. Lotus is backed by Kleiner Perkins, CRV, clinicians at Harvard and Stanford among others.

What this role is

You’ll help build and operate the AI + data systems behind AI-driven primary care.

This is a generalist role. You may work across model training and fine-tuning, model tooling, data pipelines, retrieval/evals, and product workflows.

You’ll be close to the core system and involved in product decisions from day 1.

You’ll design and scale the data and retrieval systems that power Lotus’s clinical AI, improving correctness, traceability, and explainability in how medical information is surfaced, validated, and applied in real-world care.

You’ll help shape our real-time voice and video AI capabilities, building the foundation for intelligent, multimodal patient interactions.

What this role is not

Not a big-company role with tight scope and clear lanes.

Not a place with a formal hierarchy or long onboarding ramp.

Not a “ticket queue” job. Priorities will change week to week based on user needs, clinician feedback, safety issues, and what’s breaking.

What you’ll do

AI Agents and Product Intelligence

Build and iterate on AI agent workflows that handle multi-step clinical reasoning, tool use, and structured decision-making.

Design guardrails, fallback logic, and escalation paths to ensure safe autonomous behavior in patient-facing products.

Prototype and ship new AI-powered product features end-to-end, from model selection to UX integration.

AI Knowledge Base and Search Improvements

Improve knowledge bases so that citations resolve to original data and searches are fast, relevant, and prioritize tier‑one medical information.

Continuously enhance retrieval accuracy and data lineage tracking.

AI Data Ingestion and Integrity

Rebuild data pipelines to eliminate stale data, support clinician and patient corrections, and ensure full traceability.

Design models that sync cleanly with health data partners and credentialing authorities.

Build and maintain data curation pipelines that produce high-quality training and evaluation datasets from clinical interactions.

Voice and Video AI

Build and optimize real-time voice pipelines for patient-facing interactions, including speech‑to‑text, natural language understanding, and text-to-speech.

Develop low‑latency, streaming voice agents that can conduct clinical intake, triage, and follow‑up conversations with empathy and medical accuracy.

Fine‑tune voice and video models for medical terminology, diverse accents, and accessibility needs.

Design interruption handling, turn‑taking logic, and conversational state management for natural, fluid voice experiences.

Observability and Analytics

Build monitoring and analytics for background jobs to monitor failure rates and identify partner vs. internal issues.

Streamline tracing, logging, and auditing to reduce redundancy while maintaining compliance‑grade visibility.

Instrument model performance tracking in production — monitoring latency, token usage, output quality, and drift over time.

Model Training and Fine‑Tuning

Fine‑tune and adapt foundation models on clinical data to improve diagnostic accuracy, safety, and tone for patient-facing interactions.

Design and run training pipelines including data curation, annotation workflows, hyperparameter tuning, and model evaluation.

Develop and maintain evaluation frameworks (automated and human‑in‑the‑loop) to measure model quality, safety, and regression across releases.

Experiment with prompt engineering, RLHF, distillation, and other techniques to optimize model behavior for healthcare‑specific use cases.

What you bring

• Strong programming skills, preferably Python
• Experience with system refactors, schema migrations, and data infrastructure simplification
• Familiarity with PostgreSQL (including JSONB and vector types) and AWS
• Experience building production systems that power AI or ML workflows
• Hands‑on experience with LLM APIs, prompt engineering, and shipping AI‑powered product features
• Comfort working across the stack, from schema design to production debugging
• Familiarity with training infrastructure and frameworks (PyTorch, Hugging Face, vLLM, Axolotl, or similar)
• Experience with RLHF, DPO, or other alignment and preference‑tuning techniques
• Experience building or improving AI agent systems with tool use and multi‑step reasoning
• Experience building retrieval systems for LLMs (RAG pipelines, vector search, grounding)
• Familiarity with FastAPI, SQLAlchemy, DuckDB, Temporal, ClickHouse, Valkey, or similar systems
• Experience with real‑time voice AI systems, speech models, computer vision, medical imaging, or multimodal models that combine text, audio, and visual inputs
• Knowledge of logging/monitoring stacks (Sentry, Langfuse) and containerized deployments (Docker, ECS)
• Experience simplifying multi‑layered data systems where architectural issues cascade through storage, logging, and application layers
• Strong intuition for designing systems that balance correctness, observability, and performance

Why Lotus

We are redefining how healthcare data is understood and acted upon. You’ll work with a world‑class group of engineers, clinicians, and AI researchers to build something with lasting impact to improve healthcare.

As an AI Engineer on a small, exceptional team you’ll have the autonomy to build the systems that make our clinical AI safe, fast, and explainable. Your work will directly influence patient care at scale.

What success will look like in the first 90 days

30 days

Shipping reliably, understands the core system, owns a small surface area

60 days

Owning a meaningful system and improves a key metric (quality, latency, clinician wait time, data reliability, etc.)

90 days

Independently driving a roadmap slice and raises the team’s bar (agents/evals/monitoring)

What the interview process looks like

Short technical screen

1 deeper technical interview + team chat

References + offer

We usually wrap the process in ~7–10 days