Senior AI Engineer

Who is Recruiting from Scratch:

Recruiting from Scratch is a premier talent firm that focuses on placing the best product managers, software, and hardware talent at innovative companies. Our team is 100% remote and we work with teams across the United States to help them hire.

Senior AI Engineer
Location - San Francisco, CA (Hybrid / Onsite)
Compensation - $210,000 - $270,000 Base + Competitive Equity
Visa - TN Visa Accepted (Canadian Citizens Only)
No Other Visa Sponsorship Available
Company Stage - Series A Stage (Recently Raised Series A, Not Yet Publicly Announced)
Industry - AI, Healthcare, HealthTech, Clinical Documentation
About the Company

The company is building AI-powered clinical workflows that eliminate administrative burden for home health clinicians.

Already deployed across thousands of clinicians serving tens of thousands of patients daily, the platform automates documentation, streamlines workflows, and allows healthcare providers to spend more time delivering patient care.

Founded by experienced AI researchers and operators with backgrounds in large-scale AI systems, the company has rapidly gained traction within healthcare and recently completed a Series A financing round to support aggressive growth.

As the first dedicated AI hire, this Senior AI Engineer will own the intelligence layer of the platform, building the systems responsible for model accuracy, evaluation, inference, monitoring, and production AI workflows.

This is a rare opportunity to join an early-stage healthcare AI company with real-world deployment, proprietary clinical datasets, and significant ownership over the future of the AI organization.
What You'll Do

• Train and fine-tune open-source foundation models using proprietary healthcare datasets
• Build evaluation frameworks, benchmarks, and monitoring systems that continuously improve model quality
• Design metrics, feedback loops, and accuracy measurement systems tied to real-world clinical outcomes
• Build scalable and cost-efficient inference infrastructure for production AI systems
• Develop agentic AI workflows that clinicians rely on daily
• Improve model accuracy, latency, reliability, and observability across production environments
• Partner closely with founders and leadership on AI strategy and technical direction
• Prototype new AI capabilities and rapidly transition them into production systems
• Stay current on frontier AI research and incorporate new techniques into production workflows
• Help establish the long-term AI roadmap and eventually build and mentor the AI team

Ideal Candidate Background
Experience Requirements

• 7+ years of software engineering experience with significant AI/ML depth
• Experience training or fine-tuning open-source LLMs in production environments
• Experience building production AI systems rather than research-only projects
• Experience at Seed to Series B startups
• Experience designing evaluation frameworks and model monitoring systems
• Demonstrated ownership of AI products from experimentation through deployment
• Founding Engineer or early AI hire experience preferred
• Healthcare AI experience strongly preferred
• Experience building systems used by real customers in high-accuracy environments

Technical Requirements

• Strong Python engineering skills
• Experience fine-tuning open-source models such as LLaMA, Mistral, or similar
• Deep understanding of model evaluation and benchmarking methodologies
• Experience with LoRA, PEFT, Hugging Face, or related fine-tuning frameworks
• Experience building inference infrastructure and model-serving systems
• Experience with agentic systems, orchestration, and tool usage frameworks
• Experience with monitoring, observability, and production AI operations
• Familiarity with vector databases, retrieval systems, and RAG architectures
• Strong system design and architecture fundamentals

Education

• Degree in Computer Science, Machine Learning, AI, or related technical field
• Graduate degree (MS or PhD) in AI, NLP, ML, or related field strongly preferred

Soft Skills

• High ownership mentality
• Strong communication and collaboration skills
• Ability to operate independently
• Comfortable working in ambiguity
• Strong product judgment
• Startup mindset and bias toward execution
• Passion for healthcare impact

Preferred Backgrounds

• Healthcare AI startups
• Clinical documentation AI companies
• Voice AI and healthcare NLP platforms
• Early-stage venture-backed startups
• Founding AI Engineer backgrounds
• Teams deploying production LLM systems
• Organizations focused on model evaluation and accuracy

Compensation & Benefits

• Base Salary: $210,000 - $270,000
• Competitive Equity Package
• Significant ownership over AI strategy and architecture
• Direct collaboration with founders
• Opportunity to build and lead the AI function
• Access to proprietary healthcare datasets
• Meaningful impact on clinician productivity and patient care
• Hybrid or onsite flexibility in San Francisco
• Rapid career growth as the company scales

Why Join

This is an opportunity to become the first dedicated AI hire at a rapidly growing healthcare AI company with real-world deployment and meaningful clinical impact.

You'll own the entire intelligence layer-from model training and evaluation to inference infrastructure and agentic workflows-while working with proprietary healthcare datasets that create substantial defensibility and model advantages.

As the company scales through Series A and beyond, you'll have outsized influence on technical direction, hiring, architecture, and product strategy while helping build AI systems that clinicians depend on every day.