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Berry Street is building AI-native healthcare infrastructure at the intersection of AI, GLP-1 therapeutics, and consumerized care. The platform connects patients with 2,000+ clinicians and AI tools to treat obesity, diabetes, cardiovascular disease, kidney disease, maternal health, and other chronic conditions. Operating across all 50 states with major health plans and health systems, the company has served hundreds of thousands of patients since launching in 2023 and is Series B-backed by Khosla, Northzone, FJ Labs, and founders from Revolut, Grow Therapy, and Spring Health.
In this founding-caliber engineering role, you will work directly with the founder and leadership team to architect AI-native infrastructure and consumer experiences. You'll be one of a small number of engineers shaping how the system scales from hundreds of thousands to millions of patients globally.
Key responsibilities include:
- Architect and ship AI-native systems from the ground up: autonomous clinical agents, LLM-powered workflows that replace manual processes, intelligent tools that enhance clinician effectiveness and enable GLP-1 prescribing and monitoring at scale
- Build infrastructure that makes AI reliable in clinical settings: evaluation pipelines, guardrails, feedback loops, and production-grade systems that differentiate between demos and products
- Set technical direction on the platform, making architectural decisions that enable scaling from tens of thousands to millions of patients
- Own features end-to-end across provider- and patient-facing surfaces, from scoping and architecture through production deployment
- Serve as a force multiplier for the engineering team by raising standards on code quality, tooling, and practices without slowing velocity
- Work directly with patients and providers to understand real needs and translate them into systems that scale
Tech stack: React, React Native, TypeScript, Next.js, NestJS, TailwindCSS, TypeORM, PostgreSQL, AWS.
**Requirements:**
- 5+ years of production engineering experience building and maintaining systems at scale; demonstrated ability to make hard architectural decisions and own the consequences
- AI-led architecture expertise, not AI-assisted development; experience shipping autonomous AI systems and architecting AI-driven platforms from the ground up; opinions on where AI is heading and building for that future
- Product-oriented mindset: think about users and systems holistically, push back on specs that don't make sense, drive for understanding the 'why'
- Full-stack capability with backend strength; proficiency with React, Next.js, NestJS, TypeORM, PostgreSQL, AWS; comfort with TypeScript and TailwindCSS
- Ownership mindset: take projects from vague idea to shipped and working without hand-holding; flag problems early, drive decisions, follow through
- Bias for speed with judgment about when to move fast versus when to build carefully; understand the difference between velocity and cutting corners
