Founding Engineer (AI-Native Ops Infra)

Legion Health (YC S21) | Founding Engineer (AI-Native Ops Infra) | San Francisco | ONSITE | VISA SPONSORSHIP | $130k–$190k + Equity Legion Health is building the AI-native operations layer for mental health care. We run our own psychiatric practice and use AI agents to handle the complex "backend" of healthcare—scheduling, intake, documentation, billing, and risk detection. We have $3M+ ARR, $7M+ raised, and our infrastructure currently supports 2,000+ patients with only one human support lead. We're hiring a Founding Engineer to own our backend and agent systems end-to-end. This is not a "wrapper" role; you will be architecting the state machines and event streams that turn clinical intent into reliable operations. The Role: Build AI Co-workers: Implement agents with tool use, memory, and safety rails that act as trustworthy teammates for clinicians. Event-Driven Architecture: Design the schemas and workflows (Node.js/TypeScript/Postgres) that encode how psychiatric care operates. High Impact: Your work lands in real clinical workflows immediately, directly improving patient access and care quality. Tech Stack: Node.js, TypeScript, Supabase (Postgres), AWS (ECS/Lambda), Next.js 15, OpenAI/Anthropic. Offer: Comp: $130k–$190k base + significant early equity (0.2%–0.8%). Location: San Francisco (In-person). Process: Intro -> Systems Deep Dive -> Practical Work Trial (No Leetcode) -> Onsite. We move fast (7-10 days). Email me at yash@legion.health if you have questions or if you're super cracked and I have to know about you. Apply here: https://jobs.ashbyhq.com/legionhealth/ffdd2b52-eb21-489e-b12...