Chief Technology Officer

PERMA FAIR•Camden, NJ

1d•$275,000 - $325,000

About The Position

PermaFAIR operates a proprietary healthcare claims repricing platform built on .NET 8 and EDI Fabric, running on Azure. We ingest and reprice 837P (professional) and 837I (institutional) claim transactions at scale, delivering measurable savings for self-funded plans and the TPAs, brokers, and consultants who serve them. We’re at an inflection point. The repricing engine is mature; the next chapter is three things at once: (1) productizing our CRM/CSR engagement layer as a true multi-tenant SaaS on Microsoft Dynamics 365 + Azure, (2) embedding AI deeply into the repricing workflow, and (3) operating the business itself on an agentic, AI-native foundation. We’re looking for the technical leader who will architect and build that future shoulder-to-shoulder with the CEO.

Requirements

10+ years building production systems, with recent years as a Principal Engineer, Software Architect, Founding Engineer, or hands-on CTO.
Deep Microsoft stack fluency: Azure (Service Bus, Event Grid, APIM, Functions, Logic Apps), Dynamics 365 (Sales + Customer Service), Dataverse, Power Platform, Entra ID. You’ve designed cross-tenant federation in production.
Healthcare claims domain: hands-on experience with EDI X12 (837/834/835), CMS-1500 and UB-04, ERISA/Taft-Hartley plan structures, repricing or negotiation workflows. Non-negotiable.
Multi-tenant SaaS scars: you’ve taken at least one platform from single-tenant or internal to a real multi-tenant SaaS — tenant isolation, billing, onboarding, SLAs, the unglamorous parts.
HIPAA-grade compliance instincts: Zero Trust, BAA structuring, PHI handling, audit trails. You know what an Azure HIPAA architecture should look like without being told.
.NET 8 depth.
Business sense: you can follow a P&L, understand unit economics, and translate operational pain into agentic automation instead of headcount.
Must be authorized to work in the United States on a full-time basis without Company sponsorship.

Nice To Haves

Prior Founding CTO, CTO, or VP Engineering role at an early-stage company.
Power Platform / Dataverse low-code depth.
Experience with TPAs, payers, brokers, or self-funded plan administration.
Azure DevOps and IaC (Bicep / Terraform) at production scale.
Production agentic systems (LangGraph, AutoGen, Semantic Kernel, or custom orchestration).
You are orchestrating agents and creating agentic workflows using tools like Copilot Studio, OpenHands, or OpenClaw.
You are building scalable evaluation pipelines to validate model behavior and performance for LLM optimization.

Responsibilities

Design and build a model-agnostic AI abstraction layer: champion/challenger routing, price-aware model switching, fallback chains, evaluation pipelines, cost telemetry, prompt versioning.
Lead the integration of AI into the existing .NET 8 / EDI Fabric repricing engine — claim classification, exception triage, negotiation assist, document parsing, and citation-grade retrieval over plan documents (SPDs, SPCs, ERISA, Taft-Hartley, state and local regs).
Build internal agents that run the business: task and project agents, eval agents that grade other agents, compliance attestation agents, onboarding agents.
Own the full Microsoft stack: Azure (Service Bus, Event Grid, APIM, Functions, Logic Apps, Dataverse, Synapse Link, ADLS, Key Vault, Entra ID), Dynamics 365 (Sales + Customer Service), Power Platform, Azure AI Search, Azure OpenAI.
Set the bar for security, HIPAA/GDPR compliance, Zero Trust, observability, and CI/CD.
Lead and grow a small, senior internal team.
Direct outside vendors and implementation partners.
Hold the engineering quality line.
Take the CRM/CSR engagement layer (Dynamics 365 + Azure) from internal platform to a real, sellable multi-tenant SaaS product. Tenant isolation, onboarding, entitlement, metering, SLA enforcement, and cross-tenant federation via Entra B2B, APIM, Event Grid, and Synapse Link.