True Talent Solutions Partners
Founding Engineer
Backend-leaning founding engineer at an early-stage healthtech startup: owns core platform architecture (APIs, database design, backups, observability) and builds a real-time drug pricing system, claims adjudication engine, and payment infrastructure using Python, FastAPI, PostgreSQL, GCP, React, and TypeScript.
- Compensation
- $210K–$260K / yr
- Location
- New York
- Work setup
- Onsite
- Seniority
- Not specified
- Employment
- Not specified
- Experience
- Not specified
- Category
- Software engineering
- Posted
Skills
Must have
- 3-8 years of backend or full-stack engineering experience
- Strong backend, architecture, and database schema design skills
- Experience building and operating production systems where downtime or errors have direct financial or operational impact (payments, ledgers, trading, critical infrastructure)
- Proficiency with Python, FastAPI, and PostgreSQL
- Experience with row-level security
- Experience with GCP, Cloud Run, and Cloud SQL
- Proficiency with React and TypeScript
- Familiarity with AI development tools such as Claude Code or Cursor
- Comfort operating as the sole engineer at an early-stage startup, making architecture decisions, and constructively challenging technical assumptions
Nice to have
- Startup experience alongside experience in larger technology organizations
Full description
About the Role
Join an early-stage healthtech team as its backend-leaning Founding Engineer. You will own core platform architecture and build reliable systems that support prescription pricing, claims processing, and payments.
What You'll Do
- Own the backend, including APIs, database design, permissions, sensitive health data boundaries, backups, staging, observability, and deployments.
- Build and operate a real-time drug pricing system that gathers prices from multiple sources and routes claims to cost-effective options.
- Manage eligibility and claims flows through an adjudication engine, ensuring failures do not disrupt access to medication.
- Build a claims adjudication engine and validate it against a current system using replayed claims.
- Own payment infrastructure between brokers and pharmacies, with high availability and financial accuracy requirements.
- Make foundational architecture and schema decisions as the platform scales.
What We're Looking For
- Three to eight years of backend or full-stack engineering experience, with strong backend, architecture, and database schema design skills.
- Experience building and operating production systems where downtime or errors have direct financial or operational impact, such as payments, ledgers, trading, or critical infrastructure.
- Proficiency with Python, FastAPI, PostgreSQL, row-level security, GCP, Cloud Run, Cloud SQL, React, and TypeScript.
- Familiarity with AI development tools such as Claude Code or Cursor.
- Comfort operating as the sole engineer at an early-stage startup, making architecture decisions, and constructively challenging technical assumptions.
- Startup experience alongside experience in larger technology organizations is valued. Experience in healthcare, health benefits, or pharmacy is not required.
Compensation & Benefits
Base salary: $210,000 to $260,000 annually. Visa sponsorship is not available.
Location
On-site in New York, New York.