we’re building a stealth primary care management services organization (MSO) from the ground up, backed by institutional capital. the company centralizes and automates non-clinical operations for primary care practices (including insurance workflows, billing, revenue cycle management, and administrative tooling) so providers can focus on patient care.

this is a true 0 to 1 founding role for an engineer who wants real ownership and is comfortable building in ambiguity. early work is foundational and operational, focused on system architecture and integrating best-in-class EHR and RCM tools rather than building everything from scratch.

this is a co-founder role in every sense, with equity, influence, and responsibility from day one.

responsibilities:

• own the initial technical strategy and stack
• select and integrate core systems (EHR, RCM, scheduling, internal tooling)
• build the glue that makes clinics operational and scalable
• make pragmatic build vs buy decisions
• set security, data, and compliance foundations
• hire and lead a small, high-caliber engineering team
• partner closely with the CEO and clinical leadership on sequencing and tradeoffs

this role is a strong fit if you are:

• an engineer first, founder second
• someone who has already chosen risk (started a company, left comfort, built without permission)
• comfortable being hands-on early
• opinionated, but pragmatic
• motivated by ownership and responsibility, not titles
• you don't need deep healthcare experience - but you do need respect for regulated, high-stakes environments and the willingness to learn fast.

must-haves:

• former founders only - we look exclusively for people who have started companies before (short, messy, or early attempts are fine)
• structured training - experience in top-tier engineering environments (faang or late-stage, high-growth startups)
• elite education - undergraduate cs or closely related degree from a top-20 university
• bias toward action - hungry, resourceful, relentlessly execution-oriented
• location: new york city

background:

• strong SWE foundation (backend, infra, systems, integrations)
• experience shipping and owning critical systems
• comfort with boring, foundational work that compounds over time
• ability to operate closely with non-technical stakeholders

stage + compensation

• stage: pre-product, pre-team, capital committed
• compensation: meaningful equity + competitive founding salary