[Hiring] Staff Software Engineer @Foundation Health

Role Description

We’ve built an AI operating system for pharmacies. It handles the operational work behind paperwork, prior auths, and care coordination. It’s live with enterprise health systems across the US, and we’re working directly with one of the biggest names in pharmacy.

As a Staff Engineer, you’ll own one of our core products: the prior auth pipelines, the Epic integrations, and the AI agents that handle patient calls and texts. You’ll make the architectural calls, write a lot of the code yourself, and set the standard for everyone else working on it. Most days you’re deep in the code. But you’re also the person who can step back, see how the product fits with the systems around it, and spot the problem coming before it lands.

Maybe you’re somewhere big, where the systems are impressive but the ownership is glacial. Maybe you’re at a startup that’s stopped being one. Either way, the itch is the same. Here the loop is: see the problem, build it, watch a pharmacist use it that week.

What you’d own

• Production agentic systems in a regulated space, covering automated workflows, LLM-assisted QA, and AI features like RAG, function calling, and evals.
• System design across your product, spanning the Epic integration, the prior auth pipelines, and the patient comms infrastructure.
• The standards on your team, setting the patterns, the review culture, and the quality bar through your own code.
• Delivery across your workstream, including roadmaps tied to product milestones and shipping software that solves the user’s problem.

What we’re looking for

• You’ve owned a product before and made the calls that shaped it.
• A track record of building complex systems from scratch, with the ability to discuss specific decisions made and why.
• You’re hands-on by default, with the ability to zoom out when the situation requires it.
• High agency; you don’t wait for a perfectly scoped ticket.
• Comfort with ambiguity, as things move fast and change often.
• You use AI tools daily and want to push that further.

Where you’ll work

This role is remote-first, but you need to be based in US Eastern or Central time. Our customers, pharmacy partners, and a lot of the team sit there, and you can’t really own a product from six hours out of sync. If you’re near Orlando, we’ve got an engineering hub downtown you’re welcome to use.

There’s no legacy estate to babysit, no change board, and no three-week sign-off loop.

The upside

We’re a Series A company of about 70 people, with roughly 40 of them being engineers. At that size, a Staff hire shapes how the product turns out. The equity reflects that: this is a meaningful grant at an early stage, not a rounding error. If this works, you’ll have built a core part of it, and you’ll own a real piece of it.

We’re backed by Define Ventures and led by a 2x founder. Our VP of Engineering came from DeepMind.