Sr. Full-Stack AI Engineer

Job title: Senior Full-Stack AI Engineer
Location: Onsite in San Francisco (5 days)
Salary: $180-250k base + equity
Requirements: 5+ years of experience, React/Python, STARTUP environment, production LLMs

The Mission

We're deploying AI into regulated healthcare environments where accuracy matters and failure isn't an option. Medical data is messy, workflows are high-stakes, and clinical oversight is non-negotiable. We're building intelligent systems that extract meaning from complex patient records and augment how clinicians work-built for rigor, auditable every step of the way. We need experienced builders who've shipped in startups and know how to move with both speed and precision.

Who We're Looking For

You've built and shipped at startup velocity. You've navigated ambiguity, made architectural bets, owned outcomes. You know when to move fast and when to slow down for rigor. You've mentored engineers, shaped technical direction, and earned trust across technical and non-technical teams. You understand that startup success isn't just about speed-it's about making the right bets and executing with discipline.

We're hiring experienced operators who've thrived in high-growth, resource-constrained environments. You need 5+ years shipping production systems, with real startup experience in your background. You're not looking for process or permission-you see a problem and you solve it.

What You'll Own

• Lead architectural decisions that shape how we deploy AI into clinical workflows at scale
• Build and mentor the technical team-set standards, review design, develop engineers
• Own major systems end-to-end: from customer discovery and requirements to architecture, implementation, and production reliability
• Set the bar for code quality, testing, and operational excellence
• Identify and build the features that expand our impact with customers
• Work directly with founders on product and technical strategy
• Navigate complex stakeholder environments (clinical, compliance, business) with authority and credibility

Responsibilities

• Define technical strategy for healthcare AI systems-scope, architect, and ship sophisticated solutions
• Build and lead intelligent data pipelines, multi-step agent workflows, and systems that parse medical information at scale
• Ensure our systems integrate seamlessly with healthcare standards and interoperability requirements
• Own deployment strategy, monitoring, and continuous improvement across production systems
• Lead by example on code quality, testing rigor, and operational discipline
• Mentor engineers on design, shipping, and technical decision-making
• Spot expansion opportunities with existing customers and new markets
• Build and maintain credibility across technical, clinical, and business stakeholders

Tech Stack

Backend: Python, FastAPI, PostgreSQL, data validation frameworks, workflow orchestration
Frontend: TypeScript, React, modern build tooling, component libraries
Infrastructure: AWS services, Terraform, containerization, GitHub Actions, monitoring/observability
AI/ML: Leading LLM providers in production

Compensation & Benefits

• $180k-$250k base (calibrated to experience and impact)
• Stock options (0.3%-1.0% range)
• Medical, dental, vision coverage
• Generous time off
• Immigration support available
• Top-tier equipment and developer tools
• San Francisco office-full-time presence required
• Regular team gatherings

Benefits

• Health, dental & vision
• Unlimited PTO
• Visa sponsorship (H-1B, O-1)
• Latest MacBook, AI coding tools
• Weekly team lunch in the SF office