Founding Full Stack Engineer

About the Role Join an early-stage healthtech SaaS startup as a Founding Full Stack Engineer, where you'll own architecture and implementation across multiple integrated products serving complex, multi-hospital enterprise customers. This is a senior, hands-on role where you'll build core infrastructure, data models, and AI-driven workflows — and help set the engineering standards that enable secure, enterprise-grade SaaS at scale. What You'll Do Own architecture and end-to-end implementation across four integrated products. Design data models that support multi-hospital and multi-unit organizational structures. Build AI workflows for document authoring, evidence organization, and document retrieval. Implement enterprise infrastructure including SSO/SAML, RBAC, audit logging, and HRIS integrations. Translate customer calls and domain knowledge into shipped product features. Define and maintain CI/CD pipelines, testing strategies, and architectural standards. Collaborate with product teams and non-technical stakeholders to align engineering with clinical and operational needs. What We're Looking For 5+ years building production SaaS products with end-to-end ownership. Strong full-stack experience with TypeScript, React, and Node.js. Proven backend design experience for multi-tenant, workflow-heavy applications — this is a dealbreaker requirement. Experience implementing enterprise auth systems (SSO/SAML) and integrations (RBAC, audit logging, HRIS) — dealbreaker requirement. Hands-on experience with AI-assisted workflows for writing, evidence organization, or document retrieval. Demonstrated ability to own architecture and execution in an early-stage startup environment. Strong communicator comfortable working with non-technical domain experts and customers. Experience defining CI/CD, testing strategies, and standards for growing engineering teams. Nice to have: Familiarity with Next.js, PostgreSQL, Supabase, Vercel, or AWS S3. Please note: Visa sponsorship is not available for this role. Compensation & Benefits Salary: $135,000 – $155,000 USD annually Early-stage equity opportunity Location This is an on-site role based in San Francisco, CA. Candidates must be based in or willing to relocate to the San Francisco Bay Area.