Summary
Shape the architecture of an early-stage technology platform, make key engineering decisions, build scalable systems, and help grow a high-impact engineering team.
Highlights
Foundational technical ownership, significant equity, close collaboration with leadership, and the opportunity to build and grow an engineering organization.
Description
San Francisco, CA (Hybrid Preferred) | Competitive Salary + Meaningful Equity
We’re partnering with an early-stage, venture-backed public safety technology company using AI and automation to transform revenue cycle management for emergency medical services (EMS).
Ambulance agencies operate in one of the most complex and overlooked areas of healthcare, navigating highly manual billing, claims, denials, and reimbursement workflows.
This company is building technology to automate these processes and help EMS agencies get paid more accurately and efficiently.
They’re hiring a Founding Engineer / Tech Lead to own the technical architecture end-to-end and help build the next generation of the platform.
This is an opportunity to architect systems from the ground up, make foundational technical decisions, and eventually help build and lead the engineering organization — while remaining deeply hands-on.
What You’ll Do
Architect and build new systems from scratch across backend, frontend, infrastructure, DevOps, and security.Own key decisions around APIs, data models, infrastructure, scalability, and build-vs-buy.Work directly with the founder to shape the technical roadmap.Identify bottlenecks and evolve the architecture as customers and usage scale.Establish engineering best practices and technical standards.Mentor and eventually help build a small engineering team while continuing to write code.
What We’re Looking For
Strong 0→1 experience taking a product or system from concept through production.Early-stage startup experience, ideally Seed–Series B.Broad full-stack engineering experience across backend, frontend, infrastructure, and DevOps.Experience personally designing systems and making meaningful architectural decisions.Strong understanding of scalability, reliability, and technical trade-offs.A hands-on Tech Lead, Senior, Staff, or Founding Engineer who has mentored or guided other engineers without moving away from the code.A builder mentality — resourceful, highly autonomous, and comfortable operating in ambiguity.
Strong Pluses
Experience as a Founding Engineer, first engineer, or employee #1–10.Healthcare experience across billing, claims, RCM, payers, or clearinghouses.Previous startup or founding experience.Side projects or launched products you personally architected.
Why Join?
You’ll join early enough to genuinely shape the technical foundation of the company rather than inherit someone else’s architecture.
You’ll have significant ownership over how the product is built today, with the opportunity to grow into leading the engineering organization as the company scales — helping build the team while remaining a highly technical, hands-on le
