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.