Senior Systems Administrator

Fira Health

8d • Remote

About The Position

We are fixing US healthcare by building an AI-native physical care platform, starting with home health.
Home health is a $140B industry with less than $10B in EBITDA — 40% of revenue is spent on pure administrative waste. We automate this work with AI, creating a fundamentally different cost structure compared to incumbents. This lets us rapidly take market share by serving the 30% of patients who go untreated today.
We've built one of the best AI teams in the world (from Character AI, Scale, Palantir, Citadel, Jane Street) and paired them with a team of healthcare veterans and strategists to build a new type of healthcare company: one that delivers care at the speed of an AI company.
Our physical care platform already operates with 30pp higher gross margins than traditional home health providers. With our AI advantage, we pay nurses more, remove their admin burden, and unlock the scale economics that have been missing from this fragmented industry.
We're starting with home health, then expanding to all delivered care. Our mission is "any care, any where".
Fundamentally, our incentives are aligned with America. Every dollar in revenue we make is two dollars taken out of the healthcare system. If we succeed, so does US healthcare.
The Opportunity — Systems Infrastructure
We're scaling from 500 to 2,500 employees over the next year while integrating multiple acquired entities. Our IT infrastructure needs to match the speed of an AI company—not the bureaucracy of traditional healthcare.
We're insourcing IT operations and building a unified, secure platform across all business units. This means consolidating fragmented systems, hardening security and compliance, and creating the infrastructure that lets our clinical and AI teams move fast without breaking things. Think of it as a blend of:
• Defensive design (prevent attacks at every layer, but also prepare for breaches, minimize blast radius, and detect incidents fast)
• Greenfield architecture (you'll have latitude to design best-in-class infrastructure, not patch legacy systems)
• Frictionless operations security (tight access control with low friction — make the secure path the easy path)
You'll be one of the earliest members of our internal IT team, working directly with leadership, engineering, and operations to build the infrastructure foundation that powers care delivery across the USA.
This role is designed for you if you have a low ego, love solving problems that matter, and are ready to build infrastructure for an industry-changing company.

Requirements

• 7+ years of enterprise systems administration experience
• Demonstrated experience in HIPAA-regulated or highly compliant environments
• Strong hands-on experience with Microsoft 365, Entra ID, and Intune
• Experience with macOS administration, iOS device management, and cross-platform environments
• Proven ability to manage VPNs, firewalls, network security, and backup/disaster recovery systems
• Excellent documentation, troubleshooting, and communication skills
• Owner mindset: you'd rather be accountable for results than wait for someone else to fix the problem
• Bias to action: you hate bureaucracy and want to move fast
• Security-first thinking: you prioritize prevention, but also assume breach and design for containment, not just prevention
• Clear communicator: you can go from a messy problem to crisp documentation
• Comfort with ambiguity: you don't need a perfect brief; you can help create it
• Low ego: this is a startup, you want to get scrappy

Nice To Haves

• Healthcare, or multi-site clinical operations experience
• M&A systems integration experience—you've migrated or consolidated IT environments post-acquisition
• Jamf and Apple Business Manager administration
• Knox, or other Enterprise Device Management for tablet/mobile devices
• Virtual desktop infrastructure (VDI) experience
• Certifications: Microsoft (Azure/M365), CompTIA Security+, Jamf, CISSP

Responsibilities

• Own security posture across all systems
• Architect and maintain cloud infrastructure
• Drive M&A system integration
• Manage endpoints across a distributed workforce
• Partner with operations to enable fast, secure growth

Benefits

• A Senior Systems Administrator can expect to make a competitive base + equity, with strong upside given performance and our expansion
• Comprehensive benefits including medical, dental, and 401(k) matching

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed