Principal Software Engineer

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.

This isn't a pitch deck. Our platform is live in production inside major US health systems — including Intermountain Health — where our AI handles real patient communication over voice and SMS and plugs directly into Epic workflows. We have a public partnership with Amazon Pharmacy. We raised a $20M Series A led by Define Ventures. Our CEO is a 2x founder; our VP of Engineering came from DeepMind. We're ~70 people, past PMF, with enterprise customers pulling us forward faster than we can hire.

This is the most senior IC role in our US org — and we mean IC. You'll own architecture across multiple product areas, designing systems that can support 10–100x growth without a rewrite. But when the hardest problem in the company needs solving, you're the one who opens the editor and builds the first version. If your last few years have been slide decks and steering committees, this isn't the role. If you've been the person who prototyped the thing everyone said was impossible, keep reading.

You'll work directly with our VP of Engineering and CEO — but nobody here manages from a distance, at any level, and the Principal is no exception.