Senior Software Engineer

Watershed; United States; On-site; USD 140,000 - 190,000; Full time

Job summary

Foundation Health is building an AI operating system for pharmacy, with production deployments inside major US health systems and a partnership with Epic workflows. You will own features end-to-end from initial requirements to production delivery and customer handoff.

This role emphasizes shipping quickly in a regulated healthcare setting, leveraging Node/TypeScript/GCP, and owning your feature area with attention to metrics, logs, and user feedback. Orlando hub is available.

Qualifications

• Production systems experience with deployable, real-world systems.
• Comfort with unclear requirements and rapid iteration.
• Strong product instinct and accountability for regressions.
• Experience using AI tools integrated into workflows.

Responsibilities

• Own features end-to-end from concept through production and customer handoff.
• Ship features in a fast-moving, regulated environment.
• Monitor metrics, logs and user feedback for your area.

Skills

Production systems

Ambiguity handling

Product instinct

AI tool usage

Tools

Node.js

TypeScript

GCP

Job description

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

This isn't a pitch deck. Our platform is live in production inside major US health systems — including Intermountain Health — where our AI handles real patient communication over voice and SMS and plugs directly into Epic workflows. We have a public partnership with Amazon Pharmacy. We raised a $20M Series A led by Define Ventures. Our CEO is a 2x founder; our VP of Engineering came from DeepMind. We're ~70 people, past PMF, with enterprise customers pulling us forward faster than we can hire.

You'll own features end-to-end: from a loose product requirement, through the data model and API design, to production and into a customer's hands — sometimes within 48 hours.

Think about your last launch. How long between "this is obviously right" and "it's live"? Whether the delay was review layers, a roadmap you didn't control, or a client who kept changing their mind — that gap is the reason this role exists. No ticket factory, no hands-off managers to route decisions through, no theatre.

The technical problems you'd own

• Features built on LLMs that ship to real users in a regulated environment — which means evals, guardrails, and thinking hard about failure modes, not demo-ware
• Integration with the messy, fascinating reality of healthcare systems: Epic workflows, prior auth logic, pharmacy operations
• Full-feature architecture: data models, APIs, state, rollout — yours, end to end
• Your own feature area's health: you'll watch metrics, error logs and user feedback because it's yours, not because someone assigned you a dashboard

What we're looking for

• You've shipped production systems you can talk about in depth — the choices, the tradeoffs, what you'd do differently
• You thrive when the path isn't fully paved. Loose requirements energize you rather than block you
• Genuine product instinct: you ask "why" when a requirement feels off, and you treat regressions personally
• AI tools are already embedded in how you work, not a thing you're meaning to try

Stack is Node/TypeScript/GCP, all greenfield — but we hire engineers, not stacks.

The practical stuff

We've just opened a hub in Orlando if you ever wanted your comp to survive contact with your cost of living. And it's early enough that the equity is founding-role equity, not a rounding error.