Staff+ Software Engineer - Medsender

AI Medical Assistant® Engineer Healthcare runs on documents, and that work is still painfully manual. Medsender's AI Medical Assistant® automates the drudgery—classifying documents, extracting key fields, syncing data to EHRs, and automates workflows—so clinicians can focus on care and patients can be seen faster. In the past year alone, providers saved millions of hours using Medsender. We integrate with leading EHRs and deliver mission-critical reliability for thousands of providers. The opportunity: We're small, shipping fast, and tackling high-impact problems at the intersection of AI, healthcare data, and reliability. You'll bring deep technical judgment and help set the engineering bar for a young, high-ownership team. What You'll Do Own critical systems end-to-end: From design to production—across our AI-powered intake, referral, and document automation pipelines. Architect for scale & correctness in a regulated environment: resilient workflows, idempotent jobs, auditability, and strong observability. Ship AI features responsibly: integrate and evaluate LLMs (prompting, retrieval, eval harnesses, safety guardrails), optimize performance, and measure real-world impact. Integrate with EHRs/EMRs and third-party systems; design stable APIs and event-driven services that keep patient charts in sync. Raise the bar—mentor engineers, lead design reviews, improve our SDLC, and champion reliability. Partner with product & customers to turn ambiguous workflows into clean, scalable automation. What Success Looks Like (30/60/90) 30 days: You've shipped a production change in a core service, authored a concise design doc, and stood up dashboards for your area. 60 days: You own a system boundary and its SLOs; you've reduced a costly failure mode or shaved minutes off a common workflow. 90 days: You've led a cross-team project (e.g., a new agent deployed or new EHR connector) that measurably reduces manual touches and boosts provider throughput. What We're Looking For Senior scope: 7+ years building production systems (or equivalent impact) and a track record of leading complex projects across teams. Strong backend fundamentals: service design, data modeling, transactions, background processing, performance profiling, observability. AI in production: experience integrating models, prompt/RAG patterns, evaluation frameworks, and safety/guardrails. Pragmatic builder: you write crisp design docs, slice scope intelligently, and iterate with tight feedback loops. Excellent communicator & mentor who uplevels others and brings clarity in ambiguous domains. Security & privacy mindset (bonus if you've worked with PHI or in regulated environments). Nice to have: Ruby on Rails or Python at scale; polyglot comfort (we use Python, Ruby, JavaScript, Go). GCP & Kubernetes, and modern observability (OpenTelemetry). SQL depth (MySQL) and data pipeline experience. Early-stage startup experience (0→1 and 1→N). What We Offer Competitive salary and equity package (early exercise, extended exercise). Great health benefits! (includes health, dental, and vision). Unlimited paid time off (PTO) and holiday schedule to support work. Regular company off-sites and engineering meetups. The Job Sauce