Staff/Senior Agentic AI Engineers (Multiple roles)

Heartflow•San Francisco, CA

5h•$180,000 - $250,922•Hybrid

About The Position

Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease, the #1 cause of death worldwide, using cutting-edge technology. The flagship product—an AI-driven, non-invasive cardiac test supported by the ACC/AHA Chest Pain Guidelines called the Heartflow FFRCT Analysis—provides a color-coded, 3D model of a patient’s coronary arteries indicating the impact blockages have on blood flow to the heart. Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway that helps clinicians identify stenoses in the coronary arteries (RoadMap™Analysis), assess coronary blood flow (FFRCT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis). Our pipeline of products is growing and so is our team; join us in helping to revolutionize precision heartcare. Heartflow is a publicly traded company (HTFL) that has received international recognition for exceptional strides in healthcare innovation, is supported by medical societies around the world, cleared for use in the US, UK, Europe, Japan and Canada, and has been used for more than 500,000 patients worldwide. To accelerate this mission, we are hiring for multiple roles across both the Senior and Staff levels. As a founding member of our new Agentic AI initiatives team, you will step into a role that is a unique hybrid of platform architecture and greenfield product engineering. You won't just be consuming AI models; you will be responsible for setting up the core ecosystem that allows autonomous, intelligent agents to execute multi-step medical reasoning and data workflows securely and at scale. Whether you join us at the Senior level to drive execution or at the Staff level to help shape technical strategy and architecture, you will have a true blank-canvas opportunity to design production-grade agentic systems from scratch, directly translating our decade-plus of clinical AI success into the next generation of autonomous medical technology.

Requirements

5+ years (Senior) or 8+ years (Staff) of professional software engineering experience, with a proven track record of shipping production-grade software.
Deep, hands-on experience building applications with Large Language Models (LLMs) and a strong understanding of agentic architectures.
Experience with orchestration frameworks and vector databases.
Advanced proficiency in Python or Go, alongside a solid grasp of microservices, API design, and cloud infrastructure (AWS or GCP).
A passion for greenfield projects - you thrive in ambiguity, enjoy designing systems from scratch, and love solving complex, open-ended problems.

Nice To Haves

Experience deploying AI applications in regulated industries (Healthcare, Finance, etc.) or navigating HIPAA/GDPR compliance.
Active contributions to open-source LLM or Agentic AI frameworks.
Experience with advanced prompt engineering, fine-tuning, or RAG optimization.

Responsibilities

Design and implement a robust, secure, and scalable Agentic AI platform, establishing standard patterns for multi-agent orchestration, state management, tool usage, and memory.
Drive the technical execution of brand-new, agent-driven product features from initial ideation to production deployment. You will build systems to parse requirements, map software modules, and auto-generate test cases - boosting engineering velocity without sacrificing the compliance rigor required for FDA-cleared software.
Implement advanced guardrails, evaluation frameworks, and reasoning validation loops to ensure agent behaviors are safe, deterministic, and highly accurate within a medical context.
Enable agents to interact dynamically with complex medical data structures, Electronic Health Records (EHRs), imaging pipelines, and internal APIs.
Work closely with product managers, clinical experts, and data scientists to translate clinical needs into technical AI agent architectures.
Mentor junior/mid-level engineers, champion software engineering best practices (CI/CD, comprehensive testing, logging for non-deterministic systems), and stay ahead of the rapidly evolving AI landscape.