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Decoda Health is an AI-native operating system for modern elective-care clinics (med spas, wellness, longevity, and aesthetics practices). The platform consolidates 5–10 disconnected tools into a single system covering scheduling, charting, billing, payments, memberships, inventory, and patient communication, with AI built into every workflow including an AI front desk, ambient scribe for clinical notes, and automated follow-ups. Decoda is a Y Combinator (S23) company live in 200+ clinics, processing $150M+ in annual transactions, and has grown more than tenfold in the last six months.
As an early engineer, you will own meaningful surface area from day one, working across the full stack to ship product that clinic staff use daily. You'll design, build, and ship full-stack features end-to-end—from data model to API to UI—that clinics rely on. You'll build and harden infrastructure behind payments, patient messaging, and clinical documentation where correctness and uptime are critical. You'll integrate and productionize AI capabilities (agents, ambient scribing, automated follow-ups) into real clinical and front-desk workflows. You'll work directly with customers and founders to turn ambiguous problems into shipped product, often within days. You own quality through testing, instrumentation, and fast fixes. You'll also help set technical foundations—patterns, tooling, and standards—that the next 20 engineers will build on.
The work spans real-time patient communication (voice, text, document), payments and billing infrastructure, EMR workflows like charting and scheduling, and AI agents. You won't be boxed into one corner of the codebase.
REQUIREMENTS:
- 3+ years building and shipping production software, ideally at a startup or small team where you owned features end-to-end
- Strong fundamentals in a modern backend language and a typed frontend stack; comfortable moving across the full stack
- Solid grasp of data modeling, APIs, and relational databases (SQL)
- Bias for shipping—prefer getting something real in front of users and iterating over polishing in isolation
- Comfort with ambiguity and sense of ownership; treat ambiguous work as your responsibility
- Clear written and verbal communication; genuine interest in talking to end users
NICE TO HAVE:
- Experience in healthcare, fintech/payments, or another regulated, high-trust domain
- Hands-on work integrating LLMs or AI agents into production products
- Familiarity with cloud infrastructure (GCP), containerization (Docker/Kubernetes), and CI/CD
- Real-time systems experience (voice, messaging, event-driven architectures)
- Early-stage startup experience and track record of high output with small teams
