Principal AI Platform Engineer (Remote, Equity)

foundationhealthcareers; United States; Remote; USD 180,000 - 240,000; Full time

Benefits offered by this job

Remote-first

Equity compensation

Time-zone overlap with UK team

Job summary

foundationhealthcareers is seeking a Principal Software Engineer to shape architecture for a production AI platform used in major US health systems. The role combines deep technical ownership with engineering leadership, focusing on patient-facing AI and seamless EHR integration.

The position is remote-first across the United States, with periodic in-person time at an engineering hub and timezone overlap with UK teams. Equity is offered for an early-stage contributor role.

Qualifications

• Deep hands-on experience building large-scale systems.
• Staff-level or equivalent with production-use architecture decisions.
• Experience with LLMs beyond SDK calls, including agents and evaluations.
• Bias toward simple, well-structured systems.
• Experience in environments with strict regulatory or compliance needs.
• Proven track record solving high-impact problems.

Responsibilities

• Own end-to-end architecture across several product areas.
• Build and harden agentic AI for patient interactions (voice/SMS).
• Lead EHR integration work for queuing, automation, and 340B compliance.
• Drive platform expansion across health systems; lead migration efforts.
• Shape engineering with AI, including model selection and cost/latency tradeoffs.
• Mentor engineers and improve cross-team development practices.

Skills

Architecture design

LLMs and agents

Production systems

Healthcare compliance

Tools

LLM tooling

Guardrails & red teaming

Job description

foundationhealthcareers is seeking a Principal Software Engineer to shape architecture for a production AI platform used in major US health systems. The role combines deep technical ownership with engineering leadership, focusing on patient-facing AI and seamless EHR integration.

The position is remote-first across the United States, with periodic in-person time at an engineering hub and timezone overlap with UK teams. Equity is offered for an early-stage contributor role.