Founding Engineer
$170k - $250kDavid Joseph & Company
Job Description
Job Description
San Francisco, CA · On-site · Full-time
Compensation: $170,000–$250,000 + 0.5%–1.5% equity
A seed-stage company building AI agents that automate patient recruitment for clinical trials, coordinating across SMS, voice, and email to help research sites cut the costly delays that hold trials back — a $600B+ market where delays cost $600K–$8M per day. The platform is already deployed at scale, battle-tested across 500K+ patient interactions, 190+ sites, and 300+ trials, and is backed by a top-tier venture firm. On track for a Series A in the next 4–5 months on current revenue trajectory.
Founded 2019 · 1–10 people · Industry: AI Tools
The RoleFounding Engineer reporting directly to the CTO, owning full-stack product development as the company scales its core platform and AI agent capabilities. High-ownership work in a fast-paced, high-intensity (9-to-9) environment with no playbook. The engineering team is four today; you'll help define the architecture and shipping cadence as it grows.
What you'll be doing
- Orchestrate fleets of AI agents that coordinate patient recruitment across hundreds of clinical trials
- Build and optimize integrations into customer systems, including custom adapters for specific software versions
- Scale LLMs across voice, SMS, and email while maintaining conversation consistency and personalization
- Design AI agent workflows for domain-specific questions and calculations (e.g., BMI from height and weight)
- Develop scheduling and call-center management solutions for recruiters and clinical research coordinators
- Reverse-engineer legacy healthcare systems without public APIs to integrate with trial sites' existing stacks
Tech stack: TypeScript, Python, AWS, Next.js
Requirements- 0-6 years YOE, ideally new grad to ~5 years out
- Quant background (Jane Street, IMC) OR founding engineer OR Olympiad/ICPC
- Full-stack TypeScript + Python + AWS + Next.js
- SF in-person 5 days, high intensity (9-to-9)
- AI agent orchestration in healthcare recruitment
- Quant or competitive programming background
- Founding engineer at a top-tier startup
- Recently committed, green GitHub
- Top school pedigree (target: MIT, Stanford, Berkeley, CMU, Princeton, Harvard)
- Can articulate technical depth in conversation
- Master's-only background with no undergrad CS or equivalent track record
- No shipped production work or empty GitHub
- Cannot articulate what they have built or why they want this role
- Consulting or pure strategy background without hands-on engineering
- Career tenure below one year across recent roles
- Founding-engineer scope reporting to the CTO, with real ownership of architecture from day one
- Strong backing and proven traction at a seed-stage company already deployed at scale
- 0.5%–1.5% equity at the founding stage
Vacancy posted 21 days ago
Similar jobs that could be interesting for youBased on the Founding Engineer in San Francisco, CA vacancy
- Mentum (Acquired by Nuvocargo) is seeking a Founding Engineer in San Francisco, CA to build AI-driven solutions for supply chain automation. This role offers a unique opportunity to shape the future of the product and tackle complex challenges in AI. You will be responsible...Suggested
- Goblin Labs is hiring a Founding Engineer to design, build, and optimise core systems powering real-time AI personas. You will work on low-latency rendering pipelines, multi-modal context handling, and robust integrations with user interfaces. You’ll architect production...SuggestedRemote jobFull time
- Join Hire Hangar and work with fast-growing global companies while building a long-term career. Job Title| Founding Systems Engineer (Performance) Location | On-Site — San Francisco, CA Time Zone | PST Role Overview: We are seeking a Founding Systems Engineer to join...SuggestedContract work
- AI Talent Now is looking for a Founding Engineer in San Francisco to develop wearable AI systems for industrial settings. The role is full stack-oriented with responsibilities in core model development, backend work, and customer-facing products. The ideal candidate will...Suggested
$120k - $200k
Red Cedar Ventures seeks a Founding Engineer to build the core intelligence behind AutoSitu’s review agents. This role offers a unique opportunity to shape product direction and work closely with founders. You will develop multimodal systems that enhance construction documentation...Suggested$180k - $250k
A leading AI language learning platform is hiring a Founding AI Systems Engineer in San Francisco. You will lead the architecture of AI systems that enhance language learning through personalized dialogue. The role requires a systems-thinking background and experience...- A technology company in San Francisco is seeking a Founding Fullstack Engineer to build scalable systems that automate complex decisions in manufacturing. Ideal candidates will have experience with data-driven agents, strong product sense, and the ability to ship production...Relocation
- TruNorth LTD is seeking a Founding Software Engineer to join its San Francisco team or London-based candidates willing to relocate in 2026. This role focuses on building enterprise-grade AI agents for Fortune 500 clientele. The ideal candidate will have a passion for early...Relocation
- Trajectory, based in San Francisco, is seeking a Founding Generalist Engineer to craft the product experience for continual learning. The role involves owning the SDK and API surfaces while working directly with founders and industry-leading partners. Ideal candidates...
- ...the company | Founding Engineer | San Francisco, CA | Company: We are building an executive voice engine (the company). This is a multi‑agent AI system that learns how a leader thinks and produces content indistinguishable from what they'd write. Think: a specialized...
United States Digital Space LLC
San Francisco, CA1 day ago $100k - $200k
...innovation. Learn more at voicecursor.ai. Role Description This is a full-time, on-site role based in the San Francisco Bay Area. As a Founding Engineer, you will play a pivotal role in shaping the technical foundation of Voice Cursor. Your day-to-day responsibilities will...Full time10 hours per weekFlexible hoursVoice Cursor
San Francisco, CA3 days ago$350k
...conversations consistent and personalized across all channels. Reverse engineering legacy healthcare systems that don’t have public APIs to... ...who desperately need them. We’re looking for exceptional founding engineers to help us realize this ambition. If you’re an engineer...Contract workNight shiftAlleviate Health
San Francisco, CA3 days ago- ...looking for someone with a founder mentality, ready to own major product and business outcomes, not just tickets. This role is part founding engineer, part forward‑deployed engineer, and part customer success when it's needed, until the CS agents we're building take that over...Live in3 days per week
withQ
San Francisco, CA2 days ago - ...Founding Engineer — AI Infrastructure / OSS / Systems Stack: Rust, Distributed Systems, Graph Infrastructure, Lakehouse Architecture, AI Agents We’re building core infrastructure for autonomous AI systems. At the center is a lakehouse‑native graph database designed for...
UMATR
San Francisco, CA3 days ago $150k - $250k
...AgentMail is building the identity and communication infrastructure for AI agents, starting with email. We are looking for a Founding Engineer with backend and infra focus to architect systems for agents as the end users. Responsibilities Design APIs that are intuitive...Work experience placementInternshipAgentMail (YC S25)
San Francisco, CA3 days ago£60k - £120k per year
...London Employment Type Full time Location Type On-site Department Engineering Compensation £60K – £120K • Offers Equity Why we're hiring... ...like? We think 9am‑6pm will bring a great cadence to work. As a Founding Engineer there will definitely be times you need to pick up...Full timeWork at officeRemote workWork from homeRelocationVisa sponsorshipWork visaRelocation packageFree visaSkilled worker visaFlexible hoursCrane Venture Partners
San Francisco, CA3 days ago- ...Founding Software Engineer | AI Agents | San Francisco or London Location: San Francisco, CA or London, UK (London-based candidates must be willing to relocate to San Francisco in 2026) This is a genuine Founding Engineer opportunity to join an Andreessen Horowitz-backed...RelocationFlexible hours
TruNorth
San Francisco, CA1 day ago - ...About the Role We're looking for founding Machine Learning Engineers (MLEs) to own and improve our core action models end-to-end— the intelligence that powers Composite's proactive automation platform. You'll work at the intersection of LLM inference, browser understanding...
Icehouseventures
San Francisco, CA5 days ago $175k - $225k
...About the Role Join a fast-moving, early-stage consumer AI startup as a Founding Engineer — a rare, high-impact position working directly alongside the founder. This is a true 1-of-1 opportunity to shape both the product and engineering culture from the ground up. The...Remote workVisa sponsorshipCLERA
San Francisco, CA2 days ago$175k - $375k
...Founding Engineer - build the platform that lets enterprises actually deploy AI agents Are you a product-minded engineer who ships fast and owns outcomes end-to-end? Have you been the person who takes something from concept to launch without waiting for a spec? Do you...H1bWork at officeVisa sponsorshipVenture Up Inc
San Francisco, CA1 day ago$200k
...of products for private market investing. As a Senior Software Engineer on Meridian, you’ll own the technical design and delivery of major... ...sequencing trade‑offs through launch and iteration. This is a founding engineer role on a zero‑to‑one product with meaningful...Work at office2 days per weekAngelList Venture
San Francisco, CA3 days ago- ...tens of thousands of members and have raised over $10M from some of the leading VC firms in Silicon Valley. Why we need you As a founding engineer, you’ll be responsible for building the engine that help clinicians practice care at the top of their licensure. From patient-...Full timeWork at officeRelocation
Dormont Manufacturing Company
San Francisco, CA2 days ago $200k
...We’re looking for a highly ambitious Founding Engineer to join a fast-growing AI startup building the next generation of developer workflows for production codebases. This is a unique opportunity to work directly with the founding team and help shape both the product and...Full timeWink
San Francisco, CA3 days ago- ...needed. No hand‑holding. No waiting for specs. You're a full‑stack engineer, an AI engineer, and a product engineer in one person. Former... ...impact this role will have. A seat at the table. This is a founding role, you'll shape the product and the company. We're building...
DataLeap
San Francisco, CA3 days ago - ...interact with AI. We are funded by leading VCs and are a startup-in-residence at the iconic design and innovation firm, IDEO. Founding Engineer To make this future possible, we’re hiring our first engineer. What we’re looking for is tenacity, creativity, and a refusal to...
Shared Context Lab
San Francisco, CA3 days ago - ...researcher who has spent his entire career in enterprise AI, leading engineering teams from seed through Series C. The broader team includes... .... We hold a high bar of excellence that starts with the founding team. Background Deploying truly impactful AI Agents today requires...
Fragment
San Francisco, CA3 days ago $180k
...People Culture Talent. We're excited to help connect talented professionals with this exceptional team! The Role We're hiring a Founding Engineer to join an early stage company building software and data infrastructure for organizations operating in a highly regulated,...Work experience placementPeople Culture Talent
San Francisco, CA5 days ago$120k - $180k
...Founding Engineer – Staff/Senior Location: San Francisco, CA Type: Full-time, In-person Flowtel is building the next-generation operating system for hospitality, powered by modern AI agents that can handle everything from booking to room service. We just launched, secured...Full timeFlowtel
San Francisco, CA3 days ago- ...platforms. Define Technical Strategy and Culture: You will collaborate closely with the founding team to shape technical strategies, influence product development, and establish our engineering culture and best practices. Proactive Problem Solving: You will drive success by...
Unbound
San Francisco, CA3 days ago - ...We’re hiring a Founding Full-Stack Engineer to join our team! This role is full-time in San Francisco at our Presidio office. Gauge helps companies show up in more AI answers. Search traffic is shifting away from Google into AI chat, and companies are figuring out how...Full timeWork at officeImmediate startShift work
Gauge
San Francisco, CA3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Founding Engineer. Be the first to apply!
