Payroll Operations Specialist

Alpaca Health; United States; Remote; USD 140,000 - 210,000; Full time

Benefits offered by this job

Competitive salary

Meaningful equity

Health benefits

Flexible PTO

Dinner when working late

Job summary

Alpaca Health is seeking a high-velocity payroll leader to own payroll operations across dozens of clinics and to own our Salsa-based payroll platform. You will configure clinics, diagnose issues, and push platform changes that reduce manual work while maintaining accuracy for clinicians across multiple states.

You’ll be the human on the other end of stressful emails and help clinic owners understand what happened, what’s being done, and when it will be fixed.

Qualifications

• Ambitious and driven to build meaningful outcomes at high velocity.
• Able to manage complex, high-volume payroll across multiple states.
• Experience with AI-assisted tooling or prototyping to automate workflows.
• Comfortable operating in unstructured environments with accountability.
• Strong ability to turn chaos into repeatable processes.

Responsibilities

• Own payroll end-to-end for dozens of clinics.
• Configure clinics and employees on Salsa; diagnose issues to root cause.
• Manage state tax, unemployment registrations, and compliance tasks.
• Provide clear, proactive payroll support to clinic owners.
• Document workflows and build scalable processes.

Skills

Ambitious

Systems thinker

AI-native

Fast-paced

Prioritization

Tools

Claude Code

Cursor

Job description

About Alpaca Health

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.

We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.

We've raised over $14M in funding from early-stage investors like Core Innovation Capital, Adverb Ventures, and South Park Commons, and are building for long-term category leadership. More importantly, we're serving hundreds of patients, while growing 30% MoM.

This role is full-time. We’re looking for candidates based in NYC or open to relocating who are open to 5 days a week in the office.

Role

Payroll is the part of our product that people notice most when it goes wrong.

Our customers are clinic owners. Many of them left larger organizations to start something of their own, and they now have RBTs and BCBAs depending on them for a correct paycheck every two weeks. When payroll works, they get to focus on clinical care. When it doesn't, it's the only thing they can think about.

You’ll own that outcome.

You’ll run payroll operations across dozens of independent clinics in multiple states — every cycle, every correction, every state registration, every confused employee asking why their check looks different this week. You’ll also own our payroll platform itself, which is powered by Salsa: configuring it, catching problems before customers do, and telling our engineering team exactly what needs to change.

This is a customer-facing role and an operations role at the same time. You’ll be the person clinic owners email when something is wrong, and the person inside Alpaca who knows more about payroll than anyone else.

There is no playbook for this yet. You’ll write it.

What You’ll Do

Run Payroll for Dozens of Clinics

Own the cycle end to end, for many separate employers at once.

This includes:

• Pre-run review and variance checks

• Hours and timesheet reconciliation against session documentation

• Approvals, funding, and submission

• Post-run verification

• Off-cycle runs, retro pay, and overtime corrections

• Terminations and final-pay deadlines

• Garnishments, reimbursements, and adjustments

You’ll build the checks that catch errors before a customer does.

Be the Owner of Our Payroll Platform

Our payroll infrastructure runs on Salsa. You’ll understand it more deeply than anyone else at Alpaca.

• Configure new clinics and new employees

• Diagnose issues down to the root cause, not the symptom

• Decide what’s a customer question, a configuration problem, or a bug

• Write the tickets our engineers work from

• Push for the platform changes that eliminate recurring manual work

You’ll constantly ask:

"Why did this happen, and how do we make it impossible next time?"

Handle Multi-State Compliance

Our clinics operate across many states, and every state has opinions.

• State tax and unemployment registrations

• TPA and third-party access setup

• Sick leave, overtime, and pay transparency requirements

• Wage notices and required disclosures

• Filing deadlines and agency correspondence

You’ll be comfortable on hold with a state agency, and you’ll document what you learn so nobody has to learn it twice.

Support Clinic Owners Directly

You’re the human on the other end of a stressful email.

• Explain a paycheck to someone who thinks it’s wrong

• Tell an owner what happened, what you’re doing about it, and when it’ll be fixed

• Walk new clinics through onboarding onto payroll

• Turn a bad payroll moment into a reason someone trusts us more

Great payroll support is clear writing under pressure

.

Build the Systems That Make This Scale

We will not staff our way through growth.

• Document every workflow, exception, and edge case

• Build the checklists, templates, and calendars that keep cycles predictable

• Use AI and automation to remove the repetitive parts of your own job

• Turn recurring escalations into product requests

You’ll leave behind a function that runs better than when you found it.

Who You Are

• You are extremely ambitious and want to build something meaningful at high velocity.

• You are comfortable working harder and moving faster than most people.

• You are AI-native—you already use tools like Claude Code, Cursor, or similar to build and prototype.

• You thrive in environments with little structure and high accountability.

• You are a systems thinker who instinctively turns chaos into repeatable processes.

• You can manage a large volume of parallel priorities without dropping details.

Why Join

• Direct exposure to company-building at an early stage.

• Real ownership of critical initiatives from day one.

• The opportunity to materially impact families and clinicians.

• A fast learning curve that few roles can match.

• Strong compensation package

• Competitive salary
• Meaningful equity
• Health benefits
• Flexible PTO
• Dinner when working late