The posting
About Foundation Health
Foundation Health is an AI operating system for pharmacy - built by a team who lived the problem firsthand, not one that came to healthcare from the outside. Every day, prior authorizations delay prescriptions, pharmacists lose hours to paperwork instead of patients, and prescriptions slip through the cracks between health systems. We believe thoughtfully applied AI can finally change that - deep, integrated infrastructure that streamlines how care is coordinated, purpose-built for the complexity of specialty pharmacy.
We're building toward a world where pharmacy teams spend their time on patients, not paperwork - where AI handles the routine so clinicians can focus on what only humans can do. Getting there takes the right people. We're looking for curious, ambitious folks who want to help solve healthcare's hardest problems - for our patients, our partners, and each other.
The Role
We've built an AI operating system for pharmacies, tackling the operational infrastructure behind things like paperwork and care coordination. It's in production with enterprise health systems across the US, and we're working directly with one of the biggest names in pharmacy.
As a Staff Engineer, you'll own the technical direction of one of our core products: the prior auth pipelines, the Epic integrations, and the AI agents that handle patient calls and texts. You'll make the architectural calls, write a lot of the code yourself, and set the standard for everyone else's. As one of the first senior engineers in our Orlando hub, you'll also shape how the team works. It's all greenfield and AI-native, and what you build is in a pharmacist's hands within days.
Maybe you're somewhere big, where the systems are impressive but the ownership is glacial. Maybe you're at a startup that's stopped being one. Either way, the itch is the same. Here, the loop is: see the problem, build it, watch a pharmacist use it that week.
The technical problems you'd own
- Production agentic systems in a regulated environment: automated workflows, LLM-assisted QA, and AI features (RAG, function calling, evals) where the output touches real patient care, so the evaluation bar is genuinely high
- Multi-component system design across a product domain, covering Epic integration, prior auth pipelines and patient communication infrastructure
- The technical bar itself, set through your own code as much as your decisions. Your PRs should be the ones people learn from
- Delivery across a workstream: cross-team dependencies, roadmaps tied to product milestones, and accountability for shipping software that solves the user's problem, not just software that passes tests
What we're looking for
- A track record of building complex systems from scratch, and the ability to talk through the specific decisions you made and why
- High agency. You don't wait for a perfectly scoped ticket; you work out what needs to happen and do it
- Comfort with ambiguity. Things move fast and change often
- You already use AI tools daily (we're Claude/Cursor-native across the team) and you're hungry to push that further
Where you'll work
This is a hybrid role, 3 days a week in our downtown Orlando office. It's not about attendance. We ship fast, and a few people round a whiteboard beats a 40-message Slack thread every time.
Our VP of Engineering works from the same office, so you're a desk away from them, not a calendar invite away. There's no legacy estate to babysit, no change board and no three-week sign-off loop.
The practical stuff
Our packages include equity, and it's early enough that it actually means something, not a rounding error. Orlando also means your comp survives contact with your cost of living, and Florida has no state income tax. We're backed by Define Ventures, led by a 2x founder, and our VP of Engineering came from DeepMind.
