Summary
What you’ll impact
Our organization is seeking a principal-level engineer to own and architect the most complex systems in an AI-driven psychiatric care platform. The role involves full ownership of critical domains, driving high‑velocity development while ensuring clinical‑grade correctness and scalability.
Responsibilities
What you'll do
- I’m hiring a principal-level engineer to own the hardest systems in our care platform, whole. Not tickets, not a lane inside someone else's architecture: entire problem spaces, from "this is a mess" to "this is done and here's the doc."
- Real domains, picked together in week one from this list, with written authority over them:
- The factory spine. Own the question of how we get maximum leverage in the era of agentic engineering. We ship 500–1,000 PRs a month with a lean team. Merge gates, migration safety, canary and rollback on a system where a bad deploy can touch patient care—this all works today. Your job will be to move us towards 10,000 while maintaining quality and rigor.
- The clinical work spine. Our event-sourced system of record for clinical work (orders, tasks, commands, receipts): the layer that lets AI agents and humans act on patient care with auditability and fail-closed checks. You’ll own the guardrails that ensure agents can safely provide broader and broader components of care.
- Agent operations in production. LLM agents doing real clinical-adjacent work with tool use, checks, and receipts. You decide how autonomy expands and ratchets upwards as proof accumulates. Your agent harness will help prescribe psychiatric medication, legally, at the second company ever allowed to.
- The data and metrics estate. Warehouse, analytics platform, and the pipelines that tell us what actually happened.
- Architecture syncs with me. You'll have the standing I give someone who has seen more systems than I have: disagree with me, make the call in your domain, unpack it for the team when asked.
Requirements
What you’ll bring
- You've owned architecture across multiple companies or many codebases: staff-plus IC, chief-architect, or platform-consulting background. You've seen a dozen ways teams ship and you have opinions with scars behind them.
- You ship daily at high volume with a fleet of AI agents. That’s table stakes. In the interview we'll ask to see your actual setup and what you let it do unsupervised. "I use Copilot sometimes" is not this.
- When handed an ambiguous, ugly, load-bearing problem, your instinct is to take it whole: read everything, decide, build, write the doc, tell us what you decided. Not to schedule a meeting about scope.
- You communicate proactively in writing. The pattern we love: a Sunday text that says "took care of it, here's the PR and what I changed."
- You hold clinical-grade correctness without losing speed: auditability, HIPAA, fail-closed defaults, invariants over vibes.
- This is a senior seat. Typically that means 10+ years and multiple systems owned end to end, but we care about the scars, not the number.
- This role is not for you if you want to manage instead of build, you need well-scoped tickets to be productive, or big-company pace feels normal to you.