Founding Engineer

hireVouch•San Francisco, CA

4d•Onsite

About The Position

They help speech, occupational, and physical therapists build their own private practices. Their AI-powered “business-in-a-box” handles everything from business setup and insurance to marketing and software, so therapists can focus on what they do best: helping children. They are a small team in San Francisco backed by industry-leading investors who share their vision to reimagine the shape of pediatric care in the US. If you’re ready to build something big, you’re in the right place. They are hiring our Founding Engineer (Full-Stack) to work in-person, 5 days/week, in San Francisco as a member of the founding team. The office is currently in Mission. This is not a 9-to-5 role. This is a chance to join an early-stage startup, work incredibly hard to build something massive, and get unmatched career growth and learning along the way. What they are building matters — to families, to therapists, and to the kids waiting for care. You’ll be an equal thought partner in product and engineering — making foundational decisions on the stack, infrastructure, and development practices. You’ll work directly with co-founders to bring the AI-powered software to life and evolve it into a scalable, secure, and delightful platform used by real clinicians and families. This role is ideal for an engineer who wants to build from zero, shape culture and architecture, and leave a tangible mark on an early healthcare startup.

Requirements

2+ years of professional experience building and scaling modern web applications
Fluent in TypeScript, React, and modern backend frameworks (Node.js, or similar)
Experience with Vercel/AWS and CI/CD pipelines
Move fast — Proficient with AI coding tools like Cursor, Codex, etc.
Strong opinions on architecture, testing, and developer experience — but value pragmatism over perfection
Excited by early-stage ambiguity and want to build real systems, not just prototypes
Thrive working in-person with a small team, iterating quickly on product and design

Nice To Haves

Experience with healthcare, regulated environments, or automation workflows
Familiarity with FHIR standard and GraphQL APIs

Responsibilities

Lead end-to-end development of the core web applications — from architecture to deployment
Design and implement AI-powered product features
Collaborate on product and technical design, shaping how the systems, APIs, and data models evolve
Build and ship features rapidly while maintaining strong engineering quality (testing, observability, CI/CD)
Establish early engineering processes, infrastructure standards, and documentation
Own technical decisions around scalability, security, and maintainability — especially given HIPAA-compliant requirements
Contribute to (and debate!) product direction, tradeoffs, and long-term technical vision
Help define the early engineering culture and assist with future technical hires