Senior Engineering Lead (San Francisco)

About our client

Pairtu was started after the founders experienced firsthand the challenges of navigating the healthcare system for their families. Arian's mom is beating pancreatic cancer today because he learned to navigate insurance rules nobody explains. Pairtus vision is simple: everyone deserves that kind of advocacy.

The company combines smart software with human advocates to guide Medicare patients through diagnoses, bills, and care plans. Pairtu is a focused team of fewer than 15, backed by investors from Omada, Oscar, and UnitedHealthcare, as well as advisors from Oscar Health, One Medical, Ro, United, Uber, and Postmates.

Pairtu operates with speed and purpose, guided by conscious leadership and a commitment to execution. They are building in a fast-moving startup environment where ownership is essential and ambiguity is expected. Professionals who thrive solving problems without waiting for direction are a natural fit.

Why This Role Matters

Pairtu is building the AI operating system for care navigationa platform that blends high-touch human support with AI-driven workflows. The market is massive ($60B+), the need is urgent, and the team has personal stakes in solving it.

The company has raised VC funding, gained healthcare traction, and now needs a founding engineer who codes at an experienced level and knows how to apply AI in production. This individual will architect, build, and ship the core product while collaborating directly with the founders on technical and product decisions.

What You Will Own

• Ship the Core Platform: Design, build, and launch patient- and advocate-facing apps, backend services, and integrations, moving fast while managing technical debt intentionally.
• Build AI-First Workflows: Use large language models, APIs, and custom models to automate intake, triage, and follow-up. Integrate AI into daily advocate tools, from summarization to proactive care nudges.
• Develop the Tech Roadmap: Translate ambiguous product needs into clear, buildable solutions, deciding what to build in-house versus integrate via third-party APIs.
• Collaborate Cross-Functionally: Work with clinical, operations, and growth leads to ensure the product solves real user problems, including joining early customer calls to observe pain points firsthand.

Ideal Profile

• 5+ years full-stack experience with backends like Ruby on Rails, Python/Django, or Elixir/Phoenix plus React/Next.js or similar frontends
• Shipped production code in healthcare or another regulated industry
• Fluency in AI development including prompt engineering, fine-tuning, API integration, vector databases, and retrieval-augmented generation pipelines
• Experience designing secure, HIPAA-compliant systems
• Background with RESTful APIs, relational databases, and cloud hosting (AWS, GCP, or platforms like Aptible/Fly.io)
• Currently 80%+ hands-on coding and committed to staying that way
• Ability to thrive in startup environments and contribute to both technical and product decisions

Bonus Experience: AI development at other startups, electronic health records or claims systems, internal tooling or workflow automation, DevOps and continuous integration for small teams, or Django and Python expertise.

Success in 12 Months

AI features will be actively used by advocates, reducing manual workload. Scalability, security, and compliance will be proven in real-world use. Early technical decisions will be enabling rapid iteration rather than creating barriers.

The Package

• Base Salary: $120k$250k (DOE)
• Equity: 0.5%2% ownership from Day 1
• Flex: Primarily SF-based but open to some remote work, with travel once per month to offices
• Ownership: Direct visibility to the CEO/COO and leadership team from Day 1