Full Stack Engineer – Hybrid (4560)

Job Title:

Full-Stack / AI Software Engineer (Founding Engineer Track)

Role Overview

Join a rapidly scaling healthtech startup transforming front-desk healthcare operations through real-time voice automation, agentic systems, and ultra-low-latency AI infrastructure. As a Full-Stack / AI Software Engineer, you will help architect, scale, and harden the production systems that power fully autonomous scheduling, insurance verification, and patient-facing workflows used across clinics nationwide.

You will work directly with the CTO (a deep LLM/agentic systems expert) on core architecture spanning TypeScript, PostgreSQL, and Cloudflare’s edge/serverless ecosystem. This role demands someone highly autonomous, adaptable, and capable of thinking across LLM inference, media streaming, telephony-scale concurrency, and HIPAA-grade security. You will help evolve existing agentic systems already heading into production while building new ones for upcoming workflows.

This is a high-impact, high-ownership opportunity with a path to Founding Engineer or future Head of Engineering, depending on capability and ambition.

Key Responsibilities

• Build and deploy LLM-powered, agentic applications and backend services using TypeScript.
• Enhance and scale existing agentic systems; design new agentic workflows for upcoming front-desk operations.
• Architect and optimize PostgreSQL schemas; manage migrations, indexing, query performance, and Supabase integration (auth, RLS, storage).
• Develop serverless logic using Cloudflare Workers, including Durable Objects, Queues, KV, and R2.
• Design and maintain RESTful and event-driven APIs optimized for ultra-low latency and high concurrency.
• Implement and scale real-time media/voice streaming, including WebRTC audio/video, LLM conversation streaming, telephony pathways, and event-driven call flows.
• Deploy or manage inference systems across multiple providers; ability to run open-source models or custom inference pipelines is a strong plus.
• Ensure security-by-design, HIPAA/PHI compliance, and robust API/application security.
• Collaborate closely with the CTO and product leadership; operate with light requirements and high autonomy.
• Contribute to architectural docs, observability, troubleshooting, and continuous performance improvements across the stack.

Education & Qualifications

Must-haves:

• 4+ years building full-stack or backend-heavy production systems.
• Strong TypeScript, Node.js, and general JavaScript fundamentals.
• Deep PostgreSQL experience; migrations, indexing, performance tuning.
• Hands-on serverless experience (Cloudflare Workers strongly preferred).
• Direct experience with LLMs in production: tool/function calling, agentic loops, inference pipelines, or equivalent.
• Real-time systems exposure: media streaming, WebRTC, or high-concurrency real-time communication.
• Strong understanding of authN/authZ, secure coding, and distributed system fundamentals.
• Conversational fluency in Python for inference or backend integration.

Nice-to-haves:

• Experience deploying open-source models or custom inference stacks.
• Telephony experience (Twilio, Daily, Agora, Vonage, SIP, etc.).
• Experience with Supabase or other BaaS ecosystems.
• Familiarity with pgvector, RAG strategies, PEFT, or LLM fine-tuning.
• Knowledge of Cloudflare platform tools (KV, Durable Objects, Queues, R2).
• Observability and testing frameworks such as OpenTelemetry, Sentry, Playwright, Vitest, or Jest.
• Background in HIPAA/PHI compliance (preferred but less important than AI/agentic expertise).

Who Thrives Here

• Highly autonomous engineers who prefer light product requirements and can self-scope and independently solve complex problems.
• Builders who enjoy “greenfield-plus-scale” work: extending an existing alpha product while designing new agentic systems from scratch.
• Engineers with extreme attention to detail who naturally consider latency, scalability, cost, and security in every design choice.
• Individuals excited by fast iteration, ambiguity, and scrappy startup environments.
• People who deeply incorporate AI tooling (IDE integration, background agents, automated PRs/code review) into their daily workflow.

Why Us

• Most critical hire for the company; direct collaboration with the CTO on high-impact, production-critical systems.
• Immediate ownership of AI telephony, agentic workflows, and next-generation automation capabilities.
• Clear path to Founding Engineer or Head of Engineering depending on skillset and career goals.
• Hybrid flexibility: Salt Lake City strongly preferred; LA acceptable with monthly travel; exceptional remote candidates considered.
• Competitive base compensation $140,000–$200,000+ DOE, with flexibility for exceptional profiles.
• Meaningful early-stage equity (0.5 percent to 2 percent depending on impact and seniority).

Benefits

• Health, dental, and vision coverage.
• Flexible PTO and sick leave aligned with a sustainable, non–hustle-culture environment.
• Hybrid/remote work flexibility with covered or reimbursed travel for in-person collaboration.
• High-performance hardware and modern development tools.
• Learning and professional development budget supporting AI, cloud, and engineering upskilling.
• Supportive culture that values autonomy, ownership, and work–life balance.

Applicants must be currently authorized to work in the United States on a full-time basis now and in the future. This position does not offer sponsorship.

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