Staff Engineer (AI Operating System for Pharmacy)

Foundation Health is an AI operating system for pharmacy, built by a team deeply embedded in healthcare. Their mission is to eliminate delays caused by prior authorizations, reduce pharmacists' paperwork burden, and streamline care coordination using AI. They aim to empower pharmacy teams to focus on patients rather than administrative tasks.

About the Role

Foundation Health has developed an AI-driven system for pharmacies, handling operational tasks like prior authorizations, Epic integrations, and AI agents managing patient communications. As a Staff Engineer, you will:

• Own core products, including prior auth pipelines, Epic integrations, and AI agents for patient calls and texts.
• Make critical architectural decisions, write substantial portions of the code, and set high standards for the team.
• Balance deep technical work with strategic oversight, ensuring the product aligns seamlessly with broader systems.

This role is ideal for engineers who thrive in environments where ownership is immediate and impact is tangible.

What You’ll Own

• Production agentic systems in a regulated healthcare space, including automated workflows, LLM-assisted QA, and AI features like RAG (Retrieval-Augmented Generation), function calling, and evaluation systems. The systems directly impact real patient care, so reliability and accuracy are non-negotiable.

• System design across your product, covering Epic integration, prior authorization pipelines, and patient communication infrastructure, with a focus on integration with the broader platform.

• Establishing team standards, including coding patterns, review culture, and quality benchmarks. Your pull requests should serve as learning examples for the team.

• Delivering on workstreams tied to product milestones, managing cross-team dependencies, and ensuring software solves user problems effectively, not just passes tests.

What We’re Looking For

• Proven experience owning a product and making pivotal decisions that shaped its direction. You understand the pain points when it fails.

• A track record of building complex systems from scratch. Be prepared to discuss specific design choices and their rationale.

• Hands-on by default, with the ability to zoom out and see the bigger picture when necessary.

• High initiative; you don’t wait for perfect scope. You identify what needs to be done and execute.

• Comfort with ambiguity, as projects evolve rapidly and priorities shift often.

• Daily use of AI tools (preferably Claude or Cursor) and a desire to push AI integration further.

Where You’ll Work

The role is remote-first, but requires you to be based in the US Eastern or Central time zone. Foundation Health’s customers, pharmacy partners, and many team members are located there. If you’re near Orlando, you’re welcome to use their engineering hub downtown.

There’s no legacy system maintenance, no lengthy change boards, and no prolonged sign-off processes.

The Upside

Foundation Health is a Series A company with approximately 70 employees, of which 40 are engineers. As a Staff Engineer, you’ll significantly influence the product’s direction. The equity grant reflects this meaningful ownership stake at an early stage. If successful, you’ll have built a core part of the system and own a substantial piece of the company.

They are backed by Define Ventures and led by two-time founders. Their VP of Engineering previously worked at DeepMind.