Senior Founding Engineer, Platform

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.

Title of Role: Senior Founding Engineer, Platform
Location: New York / San Francisco / Remote (Hybrid - 3 days/week onsite in NY or SF)
Company Stage of Funding: Series A (~$12M raised)
Office Type: Hybrid
Salary: $160,000 - $200,000 + Competitive Equity
Visa: Visa sponsorship not available (relocation support available)
Company Description

Our client is a fast-growing healthcare AI company building the operating system for autism care.

The company provides AI-powered infrastructure that enables clinicians to start, run, and scale autism therapy practices by automating core operational workflows including billing, scheduling, payroll, documentation, and patient communication.

The company has seen rapid traction, growing ~30% month-over-month and already supporting hundreds of children across dozens of clinics. In under a year, they have scaled from zero to multi-million dollar revenue and raised a $10M Series A.

Backed by top-tier investors and experienced operators, the company is building foundational infrastructure for modern autism care delivery - combining healthcare operations with AI-driven automation.
What You Will Do

Lead architecture and execution of core platform systems powering healthcare operations
Own backend systems for payouts, payroll, billing, and financial infrastructure
Design and maintain core data models, state machines, and system logic
Build production-grade backend services in Python (70-90% backend focus)
Design schema migrations and evolve production systems safely
Build infrastructure for LLM-powered clinical workflows
Ensure systems are auditable, reliable, and HIPAA-compliant
Design APIs and backend contracts for platform features
Work closely with product and clinical operations teams
Own platform stability and system correctness end-to-end
Make architectural decisions for scalability and long-term reliability
Help stabilize early-stage production systems under rapid growth
Ideal Candidate Background

4-10 years of backend or fullstack engineering experience
Strong Python backend experience in production systems
Experience in high-accuracy environments (fintech, healthcare, insurance)
Strong system design and architecture experience
Experience building production APIs and backend services
Strong data modeling and database design skills
Experience at Series A-C or high-growth startups
Ability to work independently with minimal guidance
Preferred

Fintech, healthcare, or regulated systems experience
Stripe, Brex, Ramp, Plaid, Gusto, or similar companies
Healthcare tech experience (Grow Therapy, Headway, Candid Health, etc.)
Experience with NoSQL (MongoDB, Firebase, etc.)
Exposure to LLMs or AI systems in production
Event-driven systems or state machine design
Financial systems (ledger, payroll, payouts) experience
Strong Signals

Strong backend ownership in production systems
Experience building correctness-critical infrastructure
Stripe / Brex / Ramp / Plaid-type engineering background
Healthcare or fintech domain exposure
Strong CS fundamentals and system design ability
Ownership of architecture decisions in prior roles
Experience shipping in fast-growing startups
High attention to detail and production rigor
Compensation and Benefits

Base salary: $160,000 - $200,000
Equity: Competitive early-stage equity
Hybrid work: 3 days/week onsite in NYC or SF
Relocation support available
High ownership founding engineer role
Direct access to founders and leadership
Opportunity to define core platform architecture
Why Join

This is a high-impact founding engineering role building the core systems behind healthcare operations for autism care providers.

You will own the platform architecture powering billing, payroll, scheduling, and clinical workflows used in real production environments.

This role offers the opportunity to build foundational infrastructure in a fast-growing, mission-critical healthcare domain with strong real-world impact.