Principal Engineer

About Foundation Health

Foundation Health is transforming healthcare through an AI-powered digital pharmacy platform that seamlessly connects operational infrastructure with high quality patient experiences. Our mission is to transform patient centric care by connecting fragmented infrastructure, optimizing care coordination, and removing friction from the patient journey. We refuse to adhere to the status quo; instead, we actively pioneer solutions that will shape the healthcare practices of tomorrow.

This ambitious vision is only achievable with the dedication of the right team propelling us forward. We firmly believe that a supportive and inspiring work environment fuels creativity, transforming it into groundbreaking innovation. It is this very innovation that not only benefits our organization but also positively impacts our people, partners, and most importantly, our patients.

At Foundation Health, we foster a culture that encourages our team members to broaden their horizons, urging them to bring their passion and curiosity to the workplace each day. We understand that diverse perspectives fuel progress, and we actively seek individuals who share our commitment to excellence and forward-thinking.

Fixing Healthcare, One System at a Time

Healthcare runs on workflows built in the 90s. We're changing that - specifically in pharmacy, where we're building AI-powered infrastructure that plugs directly into Electronic Health Records and helps health systems operate at scale. Not a chatbot. Real, deep infrastructure that changes how care gets delivered.

We're Series A, already live with enterprise-level customers. The product works, people want it - now we're in building mode.

The Role

This is the most senior individual contributor position in our new Orlando hub - and it's a big one.

You'll be working directly alongside our VP of Engineering (ex-DeepMind/Google) as the technical anchor for the hub. That means owning architecture across multiple product areas, setting the standards others build to, and making the kind of calls that shape where this platform is in two years - not just this quarter.

Crucially - this isn't a purely strategic role. We need someone who can lead system design and get into the codebase when it matters. At Foundation Health, technical credibility comes from doing, not just directing.

And you're doing all of this on a completely greenfield codebase. No legacy applications, no decade-old technical debt, no red tape slowing you down. Just hard, interesting problems and the autonomy to solve them properly.

What you'll be doing

You'll own system design at platform level - architecting for 10-100x growth without major rewrites, establishing the patterns and standards the wider engineering org adopts, and identifying root-cause issues before they become expensive problems.

On the AI side, you'll define how we use it - not just in the product, but across the engineering organisation. Overseeing the architecture of AI-powered features (voice agents, clinical workflows), managing model selection, latency and cost tradeoffs, evaluation methodologies, and setting the quality and safety bar for everything AI-related that ships.

You'll work closely with product leadership to shape the roadmap - pushing back where needed, identifying what's high-leverage versus what's noise, and driving cross-team initiatives where success is measured by actual product outcomes, not ticket throughput.

On the people side, you'll grow the Engineers around you and help build the next generation of technical leaders in the hub.

What we're looking for

• A track record of building complex systems from scratch - and being able to get back into the code when needed, not just review it
• Strong engineering judgment - you know when to move fast and when to slow down, and you frame technical decisions in terms of business outcomes
• Genuine AI fluency - experience building AI-powered products and using AI tooling as a natural part of how you work
• High agency - you don't wait for a perfectly scoped ticket, you figure out what needs to happen and do it
• US-based, or willing to relocate to Orlando (we'll support that)

The setup

• Our stack is Node/TypeScript/GCP - greenfield, no legacy debt, no committee approvals to get something shipped. You'll get hands-on with OpenAI, Langfuse and Vertex AI, shipping features into production environments that touch real patient care.
• This is a founding role in a brand new hub. The influence here is real - on the architecture, the culture, and the direction of the engineering org. We're past the hard part of proving the product works. Now we just need to build.
• Significant equity and a VP who came from DeepMind/Google to work alongside.