Founding Full-Stack Engineer

About Outro Outro Health is the first company dedicated to helping people feel better by using less medication, rather than more. Our flagship program, Taper Management, is a virtual care program that helps people safely taper off antidepressants and other psychiatric medications. It’s based on hyperbolic tapering, the first neurobiology-based method for stopping psychiatric medications. We’ve built the best team in deprescribing, led by our co-founder Dr. Mark Horowitz—the world-leading expert in the space. Dr. Horowitz wrote the textbook on deprescribing, and has helped update national guidelines in several countries. In our first year we've developed a first-of-its-kind care model, with meaningful revenue, healthy economics, and research partnerships with leading health systems and universities. The product team builds the software that care runs on — the systems that let a small clinical team taper patients safely and reach far more of them. The next phase is refining that model and scaling it. More on Outro here: Our launch in WIRED Dr. Horowitz on NPR’s Science Friday About the Role We’re hiring a full-stack TypeScript engineer to join the team as engineer #2 at Outro. Our product surface is expanding fast, from a high-touch clinical service toward an integrated experience for patients, clinicians, and operations. You'll work directly with clinicians and operations staff to turn complex clinical workflows into thoughtful, reliable software. The work is varied, but it isn't scattered — almost everything we build is a way of capturing, reading, or acting on one question: what's happening with a patient's medication, and how are they responding? Part of the job is making sure those things add up to one clear picture of a patient, not data sitting in separate systems. Areas include: Integrations — connect Outro to insurance and data platforms, to allow us to bill insurance broadly, scale care, and deliver better results to patients. Clinical product — extend the custom tool our clinicians work in daily, e.g. integrating external services into it more deeply like patient-provider messaging, or developing AI tools to assist patient care. Patient product — scope and ship patient-facing features, e.g. launching a new educational product, or working on our React Native app. Operations support — continue development on the AI agents we’ve built for our operations team, or scope out data collection with academic research partners. End-to-end ownership — carry features from design through deployment, monitoring, and iteration on real feedback. Who You Are A TypeScript-focused product engineer who likes turning messy real-world systems into clear software. You've shipped solo — even if it was a side project with zero users — and you have enough visual taste to release a v1 that looks good. Comfortable across the stack, but leaning backend or systems-minded. You care about data modeling and domain boundaries — in particular whether what we collect from different places (forms, messages, prescriptions, notes) ends up connected or scattered. You build software that absorbs complexity without becoming painful to maintain. Good at resolving ambiguity. Hand you a vague problem and you'll talk to the right people, find the underlying need, propose a few solutions, write a clear spec, build a v1, and iterate. You thrive on ownership and don't need every requirement handed to you. Excited by a broad surface. One season clinical workflows, the next patient education, insurance integrations, or research data. You pick up unfamiliar domains fast and use that understanding to make better calls. Serious about AI tools, with opinions: where they help, where they're going, and how they change what a small team can build. Experimenting with them comes naturally to you. You have some experience under your belt. Ideally 3+ years of non-internship experience as a full-stack software engineer - but we can be flexible for the right candidate. Stack Backend: Next.js / Node.js / TypeScript. Frontend: React / Vite / Next.js. Mobile: React Native. Infra: GCP, managed via Terraform. The Team You'd be our second engineer — which roughly doubles the team, since right now it's just me, the Head of Product & Engineering, still building daily. A part-time designer is joining soon to help on the product surface. We intend to stay small on purpose: we'd rather give a few people enormous ownership and lean hard on good tooling than grow headcount. That makes this a genuine ground-floor role — real influence over what we build and how, and over the technical foundations the rest of Outro is built on. Compensation & Benefits Salary: $165,000 - $220,000 based on experience Early-Stage Equity: 0.25 - 0.75% Health Insurance: Medical, dental, and vision benefits Time Off: 20 days paid vacation + holidays Tooling: Claude / Codex / Cursor whatever you need on whatever plan you need Please apply even if you don't meet 100% of the criteria. Nobody checks every box every time and we'd love to talk to you about how and why you can see yourself growing into this role. We're also very open to candidates with non-traditional experience.