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Foundation Health is an AI operating system for pharmacy, purpose-built to streamline care coordination and operational workflows in specialty pharmacy. The company tackles real healthcare problems—prior authorizations, pharmacist paperwork burden, prescription gaps between health systems—with deeply integrated AI infrastructure rather than surface-level automation.
In this Senior Engineer role, you will own features end-to-end from loose requirements through production deployment. You'll work across the full stack: data models, APIs, LLM layers, rollout strategy, and post-launch monitoring. The pace is fast—features ship within 48 hours of conception. You'll tackle production LLM systems in a regulated healthcare environment (meaning rigorous evals, guardrails, and failure-mode analysis), integrate with complex healthcare systems (Epic workflows, prior auth logic, pharmacy operations), and maintain ownership of your feature area's health through metrics, error logs, and user feedback.
The environment is lean and collaborative. There's no ticket factory, minimal sign-off layers, and the VP of Engineering works from the same downtown Orlando office. You can sketch a data model on a whiteboard in the morning and have it in code review by afternoon.
The company is early-stage, backed by Define Ventures and led by a 2x founder. The VP of Engineering came from DeepMind. Equity packages are meaningful at this stage. The hybrid model (3 days/week in-office) is deliberate—co-location enables the fast iteration cycle. Orlando's cost of living and lack of state income tax are additional practical benefits.
Requirements:
- Demonstrated track record shipping production systems you can discuss in depth: architectural choices, tradeoffs, and lessons learned
- Comfort with ambiguity and loose requirements; you thrive when the path isn't fully paved
- Strong product instinct; you ask "why" when requirements feel off and take regressions personally
- AI tools are already integrated into your workflow, not something on a to-do list
