Principal Engineer, AI-Driven Health Platform

legionhealth; San Francisco (CA); Hybrid; USD 250,000 - 400,000; Full time

Benefits offered by this job

Health Insurance

Equity

In-person retreats

Meal stipends

Unlimited vacation

Job summary

Legion Health is hiring a principal engineer to own the hardest systems in our care platform, from the factory spine to data pipelines. You’ll ship at high velocity with AI agents, using a TypeScript/Node.js stack, with PHI-grade security and auditability.

This is a senior seat requiring 10+ years of end-to-end ownership across complex codebases. You’ll collaborate with the CTO to set direction, autonomy, and measurable outcomes, while delivering scalable, regulated healthcare software that

Qualifications

• 10+ years of architecting end-to-end software platforms.
• Experience shipping at high velocity with AI agents.
• HIPAA-compliant design and PHI security expertise.

Responsibilities

• Own the factory spine for maximum leverage with agentic engineering.
• Own the clinical work spine with auditability and safety gates.
• Lead agent operations in production with tool use and receipts.
• Own the data and metrics estate including analytics pipelines.
• Architectural alignment with CTO and domain ownership.

Skills

Staff-level architect

End-to-end ownership

AI agent orchestration

Proactive communication

Leadership experience

Tools

PostgreSQL

Next.js

AWS

LLM orchestration

Job description

Legion Health is hiring a principal engineer to own the hardest systems in our care platform, from the factory spine to data pipelines. You’ll ship at high velocity with AI agents, using a TypeScript/Node.js stack, with PHI-grade security and auditability.

This is a senior seat requiring 10+ years of end-to-end ownership across complex codebases. You’ll collaborate with the CTO to set direction, autonomy, and measurable outcomes, while delivering scalable, regulated healthcare software that