IT & Automation Lead

Ambience Healthcare•San Francisco, CA

7d•$200,000 - $225,000•Hybrid

About The Position

Ambience Healthcare is the leading AI platform for documentation, coding, and clinical workflow, built to reduce administrative burden and protect revenue integrity at the point of care. Trusted by top health systems across North America, Ambience’s platform is live across outpatient, emergency, and inpatient settings, supporting more than 100 specialties with real-time, coding-aware documentation. The platform integrates directly with Epic, Oracle Cerner, athenahealth, and other major EHRs. Founded in 2020 by Mike Ng and Nikhil Buduma, Ambience is headquartered in San Francisco and backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, Kleiner Perkins, and other leading investors. Join us in the endeavor of accelerating the path to safe & useful clinical super intelligence by becoming part of our community of problem solvers, technologists, clinicians, and innovators. Ambience is scaling fast, and our internal systems need to keep up- securely, automatically, and without slowing anyone down. You’ll be our first dedicated Corporate IT Lead, owning identity, devices, endpoints, and SaaS access across the company. This is not a ticket-queue role. You’ll build the automation and infrastructure that makes IT disappear for employees while raising the security bar across the board. You’ll design identity and device systems that scale with headcount, enforce least-privilege by default, and turn manual IT work into code. The goal: secure, compliant internal systems that people don’t think about- because they just work. Our roles are hybrid in our SF office (3x/week).

Requirements

7+ years building IT and/or corporate security systems at a startup or high-growth company
Deep Okta experience beyond admin work — you’ve designed identity programs
Strong hands-on Jamf and Intune experience in Mac/Windows environments
Automation-first: Terraform, APIs, scripting (Python, Bash, PowerShell)
Comfortable operating across security, IT, and engineering boundaries
Technology person at heart with a passion for the space and does not just see IT as a job
In SF, 3x/week in-person

Responsibilities

Identity & Access Automation — Architect Okta joiner/mover/leaver workflows with role-based access, automated provisioning, and clean deprovisioning. Eliminate standing access and manual tickets.
Device Management & Endpoint Security — Lead Jamf and Intune migrations in a mixed Mac/Windows environment. Establish compliance baselines, zero-touch provisioning, patching, and secure offboarding.
IT Infrastructure as Code — Migrate IT configs out of admin consoles into Terraform and GitOps. Version-controlled, peer-reviewed, reproducible changes across identity, MDM, and workspace systems.
SaaS Governance — Build a real SaaS inventory: tools, access, cost, and security posture. Identify shadow IT, consolidate sprawl, and run access reviews that actually get completed.