Founding Full Stack Engineer

About the Role We're an early-stage healthtech SaaS company building a unified platform that helps large healthcare organizations — including complex, multi-hospital systems — measure, manage, and prove the ROI of their nursing excellence programs. Think professional governance, clinical ladder programs, evidence-based practice, and designation readiness, all in one enterprise-grade product. As a Founding Full Stack Engineer, you'll own architecture and implementation across multiple integrated products. You'll design the core infrastructure, data models, and AI-driven workflows that translate customer insights directly into shipped features — and you'll help set the engineering standards that allow us to scale securely across enterprise healthcare customers. This is a senior, hands-on founding role with significant scope and ownership. You won't just build features — you'll shape how we build everything. What You'll Do Own architecture and implementation across four integrated product areas. Design data models that support complex multi-hospital and multi-unit organizational structures. Build AI-assisted workflows for document authoring, evidence organization, and retrieval. Implement enterprise-grade infrastructure including SSO/SAML, RBAC, audit logging, and HRIS integrations. Translate customer conversations and domain knowledge into concrete, shipped product features. Define and own CI/CD pipelines, testing strategies, and architectural standards for a growing engineering team. Collaborate closely with product and non-technical stakeholders to align engineering work with clinical and operational needs. What We're Looking For Must-haves: 5+ years building and delivering production SaaS products with end-to-end ownership. Strong full-stack proficiency with TypeScript, React, and Node.js in production environments. Proven backend design experience for multi-tenant, workflow-heavy applications. Hands-on experience implementing enterprise auth systems (SSO/SAML) and integrations such as RBAC, audit logging, and HRIS. Demonstrated ability to own architecture and execution in an early-stage startup environment. Experience defining CI/CD pipelines, testing strategies, and architectural standards for growing teams. Strong communicator — comfortable working directly with non-technical domain experts and enterprise customers. Nice-to-haves: Hands-on experience with AI-assisted workflows for writing, evidence organization, or document retrieval. Familiarity with Next.js, PostgreSQL, Supabase, Vercel, or AWS S3. Experience with data modeling for multi-hospital or multi-unit organizational structures. Background in healthcare, clinical workflows, or regulated industries. Note: Visa sponsorship is not available for this role. Candidates must be authorized to work in the United States. Compensation & Benefits Salary: $135,000 – $155,000 per year Early-stage equity commensurate with a founding engineering role Opportunity to shape the technical direction of a company from the ground up Location This role is based on-site in San Francisco, CA. Candidates should be local or willing to relocate.