Founding Head of Engineering
About The Position
Build the intelligence layer for a multi-billion-dollar federal arbitration market. Location: San Francisco or Remote | Full Time Why This Exists A federal arbitration system now determines billions of dollars in healthcare payments each year. Providers win the vast majority of disputes — yet most eligible claims are never filed because the process is manual, fragmented, and resource-intensive. The No Surprises Act created the framework. The market already exists. Today, it runs on spreadsheets, consultants, and static playbooks. We’re building the first intelligent system designed to operate inside this market. Our platform will: * Ingest and normalize messy claims data from disparate RCM systems * Identify disputes with positive expected value * Model win probability and award size across payers and geographies * Generate structured arbitration submissions using LLMs * Track outcomes and continuously refine strategy * Orchestrate thousands of disputes with auditability and compliance This is not workflow automation. It’s a continuously learning system operating in a repeated, adversarial market. Counterparties adapt. Regulations evolve. Strategy compounds. The architectural decisions made in the first year will shape the company for the next decade. This role is central to that. Why This Is Hard (and Interesting) Claims data is inconsistent, incomplete, and domain-heavy. Arbitration decisions are partially opaque. Payers change behavior over time. Regulatory guidance evolves through litigation. Every decision feeds back into future strategy. The system must operate across distributed data infrastructure, applied machine learning, LLM-powered reasoning, optimization under uncertainty, and healthcare-grade regulatory constraints — all at once. If you enjoy clean CRUD SaaS, this is not that. If you enjoy building systems where intelligence directly drives financial outcomes, this is a rare opportunity. Who We Are Recourse is being built in partnership with 25M Health, a healthtech venture firm. We have institutional backing, a shared platform team spanning engineering (full-stack, security, data science), strategy (fundraising, product, research), design (UI/UX, branding), and back-office (hiring, legal, accounting), and early access to large provider systems. We’re actively working with health system design partners and have access to $400M+ in billable claims to inform product development from day one. This is a funded, validated opportunity with real customers and real data. We’re small. We move quickly. We value clarity over theater. We care deeply about clear thinking, high ownership, intellectual honesty, direct communication, and building durable systems. The early engineering decisions will define the company for years.
Requirements
- 7+ years in software engineering, with 3–5+ years in senior technical leadership (Director, VP, or Head of Engineering)
- Experience building and scaling complex, data-intensive platforms from early stage through growth
- Strong architecture depth across workflow orchestration, ML-enabled systems, or high-volume transaction processing
- Experience deploying LLM-based features in production
- Hands-on technical depth — you still write code and review architecture while building a team
- Experience building in regulated or security-sensitive environments (HIPAA, SOC 2, financial controls, or similar)
- Experience hiring and leading small engineering teams
- Sound judgment, technical depth, and ownership mindset are required.
Nice To Haves
- Familiarity with healthcare data (claims, EDI, HL7/FHIR, clearinghouses) is a strong plus
- Experience designing systems where correctness, auditability, and financial impact were tightly coupled is highly valued.
Responsibilities
- Design the foundational data architecture across heterogeneous healthcare systems
- Define the modeling approach for expected value and win probability
- Lead production LLM integration for structured reasoning and document generation
- Build compliant, auditable workflows deeply integrated into provider systems and suitable for regulated environments
- Establish security posture — HIPAA, SOC 2 readiness, and data governance
- Recruit and lead a small, high-caliber engineering team
- Partner closely with us — including an experienced product leader with 15+ years scaling technology platforms in complex regulatory environments — on product strategy and long-term technical direction
- Write code, make structural decisions, and shape the engineering organization from the beginning.
Benefits
- standard health, dental, and vision benefits
- real vacation time
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
