The posting
Founding Engineer
Global Placement Firm is conducting a confidential search for Founding Engineers to join a small, high-growth healthcare technology company in San Francisco focused on transforming how speech, occupational, and physical therapists deliver care.
This is a high-ownership, product-minded engineering opportunity for a builder who wants to shape the product, technology stack, and engineering culture from the ground up.
The ideal candidate is someone who moves quickly, enjoys working directly with users, makes strong product decisions, and is comfortable owning problems from initial idea through production and user adoption.
Position Overview
As a Founding Engineer, you will be one of the core technical contributors responsible for building and scaling a technology platform designed to help therapists operate their own private practices.
You will work directly with therapists to understand their workflows, identify problems, and determine what should be built. This role goes beyond traditional software engineering—you will have a direct voice in product strategy, technical architecture, user experience, and company direction.
You will be expected to ship continuously, use AI aggressively to accelerate development, and prioritize learning and real-world user impact over unnecessary perfection.
Key Responsibilities
- Build and ship product features rapidly from concept through production.
- Own technical and product problems end-to-end, from identifying the opportunity to measuring user adoption.
- Work directly with therapists to understand their workflows, challenges, and needs.
- Observe users in their day-to-day environments and translate real-world problems into product solutions.
- Make critical product and technical decisions that determine what the company builds.
- Design, develop, test, deploy, and continuously improve the product.
- Use modern AI tools and technologies aggressively to accelerate software development.
- Explore ways AI can improve the product and create better experiences for therapists and their clients.
- Work closely with founders and other early team members on product strategy and technical direction.
- Help establish the company's engineering practices, architecture, and technology stack.
- Move quickly through experimentation, iteration, and deployment.
- Balance speed and simplicity with reliability and long-term scalability.
- Continuously gather user feedback and incorporate it into product development.
- Take ownership beyond narrowly defined engineering assignments.
Required Qualifications
- Strong professional software engineering experience with demonstrated ability to build and ship production products.
- Proven track record of taking ownership of projects from idea through launch.
- Strong product instincts and ability to make decisions beyond purely technical considerations.
- Experience working in a startup, early-stage, or highly entrepreneurial environment.
- Demonstrated ability to move quickly and iterate based on real-world user feedback.
- Strong communication and collaboration skills.
- Comfortable interacting directly with customers and users.
- Experience using AI-assisted development tools and/or AI technologies to accelerate development.
- Strong understanding of modern software development practices.
- Ability to operate with significant autonomy and limited process.
- Must be based in or willing to relocate to San Francisco.
- Must be comfortable working on-site five days per week in the San Francisco Mission District.
Product-Minded Engineering
This role is specifically designed for an engineer who wants to participate in what gets built, not simply how it gets built.
We're Looking For Someone Who:
- Thinks like a product builder, not just a software developer.
- Starts with the user problem before designing the technical solution.
- Enjoys talking directly with customers.
- Is comfortable observing users and learning how they actually work.
- Can turn ambiguous problems into simple, useful products.
- Makes pragmatic decisions and moves quickly.
- Prioritizes shipping and learning over unnecessary perfection.
- Takes ownership of outcomes rather than individual tickets.
- Is comfortable changing direction when user feedback indicates a better path.
- Has strong technical judgment without becoming overly attached to a particular technology or architecture.
- Is excited about using AI to fundamentally accelerate how software is built.
Ideal Candidate Profile
The ideal candidate is a high-agency, entrepreneurial engineer who wants to help build a company from an early stage.
You should be comfortable operating without extensive documentation, established processes, or large engineering teams.
You will have the opportunity to influence nearly every aspect of the technology organization and should be excited by the responsibility that comes with being one of the first engineers.
Strong candidates will have experience:
- Building products from scratch.
- Working directly with customers or end users.
- Shipping rapidly in startup environments.
- Making product decisions alongside technical decisions.
- Using AI tools to dramatically accelerate development.
- Iterating based on real-world user feedback.
- Taking ambiguous problems and turning them into shipped solutions.
- Working closely with founders and small teams.
Startup & Ownership Experience
This is a founding-stage engineering role, so recruiters should prioritize candidates who demonstrate meaningful ownership and entrepreneurial behavior.
Candidates should be able to clearly describe:
- Products they personally helped build.
- Their specific ownership within those products.
- Examples of taking a product from idea to production.
- Situations where they made product decisions rather than simply executing specifications.
- Examples of working directly with users or customers.
- How they have used AI to improve their development workflow.
- Examples of working successfully in small, resource-constrained teams.
Candidates who require highly structured environments, narrowly defined responsibilities, or extensive organizational support may not be aligned with this opportunity.
Technical & Product Environment
The role offers exposure across:
- Modern web and application development
- AI-assisted software development
- Artificial intelligence
- Healthcare technology
- Insurance and healthcare operations
- Product development
- User experience
- Workflow automation
- Billing and operational systems
- Practice management
- Customer-facing applications
- Data and integrations
The successful candidate will have the opportunity to influence the technology stack rather than simply inherit an established architecture.
Work Environment
This is a small, highly collaborative, in-person startup environment based in San Francisco's Mission District.
The team works closely together and expects engineers to participate actively in product discussions, user research, technical decisions, and day-to-day problem solving.
This is not a traditional engineering organization with multiple layers of management. Engineers are expected to communicate directly with founders and users, make decisions independently, and take ownership of meaningful business outcomes.
Compensation & Benefits
Base Salary: $160,000 – $210,000 annually Equity: 1.5% – 2.0% Employment Type: Full-Time Open Positions: 2 Work Arrangement: On-Site
Location & Schedule
Location: San Francisco, California — Mission District
Work Arrangement: On-Site
In-Office Requirement: 5 days per week
Candidates must be based in or willing to relocate to San Francisco and comfortable working in the office five days per week.
Visa Sponsorship
The company is open to visa transfers, including qualified candidates currently on OPT or H-1B who are eligible for transfer.
Why Join
This is an opportunity to join an early-stage healthcare technology company working to address a major problem affecting children, families, and therapists.
A significant number of children need speech, occupational, or physical therapy, while therapists spend substantial time dealing with administrative work rather than providing care.
The platform is designed to help therapists build and operate their own practices while handling complex operational challenges such as insurance, billing, and administrative workflows.
As a Founding Engineer, you will have the opportunity to:
- Shape the product, technology stack, and engineering culture from the ground up.
- Build products directly around real therapist needs.
- Work directly with users and founders.
- Make meaningful product and technical decisions.
- Ship continuously and see your work adopted by real users.
- Use AI to dramatically accelerate development and product innovation.
- Help build technology that can improve access to therapy for children and families.
- Join a small team at an early stage with significant opportunity for individual impact.
- Work at the intersection of healthcare, AI, software, and entrepreneurship.
Candidate Profile: What We're Not Looking For
This opportunity is best suited for engineers who are product-minded, entrepreneurial, and highly autonomous.
Candidates may not be the right fit if their experience consists primarily of:
- Highly structured engineering environments with limited individual ownership.
- Roles where product decisions are exclusively made by product management.
- Limited interaction with customers or end users.
- Working exclusively from predefined technical specifications.
- Reluctance to move quickly or iterate based on user feedback.
- Limited interest in AI-assisted development.
- A preference for narrowly defined technical responsibilities.
- Candidates unwilling or unable to relocate to San Francisco.
- Candidates unwilling to work five days per week in the office.
Confidential Search
This position is being presented by Global Placement Firm on behalf of a confidential client. Additional client and company information will be shared with qualified candidates during the recruitment process.
