Principal Software Engineer

Foundationhealth; Orlando (FL); On-site; USD 140,000 - 220,000; Full time

Benefits offered by this job

Employee stock options

Generous PTO

Remote work flexibility

Health, dental and vision plans

Flexible working

Job summary

Foundation Health is building a new engineering hub in Orlando, and as Principal Software Engineer you’ll own platform architecture, set engineering standards, and help shape the roadmap for a greenfield codebase.

You’ll work closely with senior leadership, ship AI-powered products, and mentor the next generation of engineers while delivering real patient care improvements across health systems.

Equity and a seat at the table from day one are included.

Qualifications

• Built complex systems from scratch and can dive into code
• Strong engineering judgment: balance speed and caution, frame decisions in business terms
• Genuine AI fluency: shipped AI-powered products and use AI tooling daily
• High agency: proactively drive what’s needed without waiting for tickets

Responsibilities

• Own platform architecture: design scalable systems for 10–100x growth and establish architectural patterns
• Define how we use AI across product and org: model selection, latency/cost tradeoffs, evaluation, safety
• Shape the roadmap with product leadership and drive cross-team initiatives
• Grow the engineers: mentor and develop the next generation of technical leaders

Job description

Join us in our mission to revolutionize healthcare.

Together, let's build something extraordinary that will shape the future of well-being for generations to come.

Embrace the opportunity to contribute to a team where your ideas and efforts make a tangible difference. The journey awaits - come be a part of building the future with Foundation Health

We're always looking for talented people, check out our latest job openings.

Principal Software Engineer

Address

Employment Type

Full time

Department

About Foundation Health

Foundation Health is an AI operating system for pharmacy - built by a team who lived the problem firsthand, not one that came to healthcare from the outside. Every day, prior authorizations delay prescriptions, pharmacists lose hours to paperwork instead of patients, and prescriptions slip through the cracks between health systems. We believe thoughtfully applied AI can finally change that - deep, integrated infrastructure that streamlines how care is coordinated, purpose-built for the complexity of specialty pharmacy.

We're building toward a world where pharmacy teams spend their time on patients, not paperwork - where AI handles the routine so clinicians can focus on what only humans can do. Getting there takes the right people. We're looking for curious, ambitious folks who want to help solve healthcare's hardest problems - for our patients, our partners, and each other.

The Role

You'll be the technical anchor for our brand new engineering hub in Orlando, working directly alongside our VP of Engineering (ex-DeepMind/Google) and a 2x Founder CEO.

Owning architecture across multiple product areas. Setting the standards everyone else builds to. Making the calls that decide where this platform is in two years, not just this quarter.

One thing we're clear on: this isn't an ivory-tower architect role. You'll lead system design and get into the codebase when it matters. At Foundation Health, technical credibility comes from doing, not directing.

And you're doing it on a greenfield codebase. No decade of technical debt, no committee sign-offs, no waiting three sprints for someone to approve a migration. Hard, interesting problems - and the autonomy to solve them properly.

What you'll actually do:

Own platform architecture. Design systems that handle 10-100x growth without a rewrite. Establish the patterns the wider engineering org adopts. Spot the root-cause problems before they get expensive.

Define how we use AI - everywhere. Not just in the product (voice agents, clinical workflows), but in how the engineering org itself works. You'll own model selection, latency and cost tradeoffs, evaluation methodology, and the quality and safety bar for everything AI-related that ships.

Shape the roadmap, not just execute it. Work directly with product leadership. Push back where it's needed. Separate what high-leverage from what's noise. Drive cross-team initiatives where success means product outcomes, not ticket throughput.

Grow the engineers around you. Help build the next generation of technical leaders in the hub — by example first, mentorship second.

Who we're looking for

You've built complex systems from scratch - and you can still get into the code, not just review it

Strong engineering judgment: you know when to move fast and when to slow down, and you frame technical decisions in business terms

Genuine AI fluency - you've shipped AI-powered products, and AI tooling is a natural part of how you work, not a box you tick

High agency: you don't wait for a perfectly scoped ticket, you figure out what needs to happen and do it

US-based, or willing to relocate to Orlando

The Setup:

Everything you ship touches real patient care in real health systems.

We're past product-market fit. Enterprise health systems are live on the platform and asking for more - the "will anyone buy this" question is answered. Now we build.

The influence here is real - on the architecture, the culture, and the direction of the entire engineering org. We've done the hard part of proving people want this. Now we build.

Significant equity comes with the role. So does a seat at the table from day one.

At Foundation Health, your work makes a real difference. Enjoy a culture that champions your growth and well-being, within a team that reshapes healthcare for the better.

• Employee stock option program Invest in our growth and share in Foundation Health’s success.
• Generous PTO Recharge with ample paid time off that supports your well-being.
• Remote working Work from anywhere and thrive in a flexible, digital-first environment.
• Health, dental and vision plans Comprehensive health coverage that puts your well-being first.
• Flexible working Customize your work schedule for a perfect work-life harmony.