About Health Note

Founded 2012 and Headquartered in West Hollywood, California. Health Note Inc is a private, venture-backed, healthcare technology company founded by Dr. Joshua Reischer and Aaron Rau. Health Note's AI platform is designed to help empower healthcare practitioners to provide a higher efficiency of care, in order to create an enhanced patient experience with increased accuracy of diagnosis and treatment.

About The Role

We are looking for a Senior Software Engineer who is as passionate about building with AI as they are about building AI products. This isn't a research role; it's a builder role. You will be responsible for the end-to-end journey of our most critical products: from the initial spark of an idea (0→1) to scaling and optimizing it into a powerful, reliable growth lever (1→N). As part of a cross-functional team, you will work in a cross-functional pod, partnering with product and design to rapidly experiment, measure, and iterate. Your deep understanding of both software architecture and AI capabilities will allow you to craft solutions where AI is not bolted on, but is a fundamental, elegant, and responsible part of the product's DNA. This opportunity is ideal if you thrive in fast-paced environments, want to push the boundaries of AI in product development, and join a growth-stage organization focused on healthcare—while working at the frontier of AI-enabled software. We use AI tools for every aspect of our work: from prototyping with Replit, V0, and Lovable; to building production-ready code with Cursor and ClaudeCode; integrating workflows with MCP for Jira and GitHub; conducting AI-assisted code reviews; and leveraging AI to handle small bugs and issues, freeing up time for deep development and architecture. We’re a fully distributed, remote-first, fast-growing startup. We rely heavily on strong asynchronous communication but do have core working hours (ET 11-4), particularly for engineering. Occasionally, you’ll need to flex to sync up with teammates across time zones. Our Stack:

• AI Dev Tooling: Replit, v0, Lovable, Cursor, Claude Code.
• AI Services: Langfuse, Hamming, Gitstart, CodeRabbit
• Core: Full-Stack Monorepo TypeScript (NestJS, React, Remix), Tailwind, GraphQL, PostgreSQL.
• Infrastructure: AWS, Redis, Pulumi (IaC), Docker
  
  

What You’ll Do

• 0 to 1 Prototyping to 10+ Clients & Product Creation: Rapidly translate ambiguous ideas into working prototypes and proofs-of-concept using our AI-first toolchain (e.g., Replit, v0, Lovable). Validate feasibility and user value with speed and precision.
• 10 to 100+ Clients Scaling & Growth Engineering: Take successful prototypes and lead the charge in building them into scalable, monitored, and efficient production systems. Identify and implement growth levers within the product using AI.
• AI-Native System Design: Architect and implement robust, cost-effective, and observable systems that deeply integrate LLMs (OpenAI, Anthropic, etc.) and AI services. Your designs will prioritize safety, reliability, and performance in a healthcare context.
• Developer Acceleration: Build the abstractions, internal tools, and APIs that empower every engineer on the team to leverage AI capabilities confidently and responsibly. You don't just build features; you build force multipliers.
• Lead with Tooling Mastery: Champion and deepen our use of the modern AI dev stack (Cursor, MCP, Claude Code, Graphite) to achieve unparalleled productivity and quality. You'll constantly evaluate and integrate new tools to keep us at the cutting edge.
• Mentorship & Culture: Elevate the team's technical standards through code reviews, architectural guidance, and by sharing your knowledge of AI-powered development patterns. Be a leader in our async-first, remote-native culture.
  
  

What You’ll Bring

• Proven track record of shipping 0-to-1 products and scaling them to 500k+ of users. Your portfolio of side projects is just as important as your professional experience.
• 5+ years of experience as a full-stack, shipping production software at scale.
• Deep, hands-on fluency with the modern AI dev stack. Proficient with Cursor, leverage Replit/v0 for ideas, and use AI agents (OpenCode, Aider, Void) as core parts of your daily workflow.
• Significant experience integrating, debugging, and monitoring LLMs and other AI services in real-world applications. You understand prompt engineering, cost management, latency, and evaluation frameworks.
• Proficiency in designing distributed systems, APIs (REST, GraphQL), and databases (PostgreSQL). You write clean, tested TypeScript.
• Obsess over user value, metrics, and growth loops. You think in terms of levers and outcomes, not just tasks.
• Experience building evaluation frameworks for AI features (e.g., using Langfuse, Helicone, Lunary). Nice to Haves
• Deep knowledge of RAG, vector databases, and intent classification patterns, search optimization, and building intelligent recommendation systems.
• Expertise in Infrastructure-as-Code (Pulumi, Terraform) and containerization (Docker).
• Background in healthcare, HIPAA, or other regulated environments (fintech, etc.).
• You’ve contributed to open-source projects or have a strong presence in the AI dev community.
• Experience with observability and monitoring systems (Datadog, Grafana, Sentry, Cloudwatch, etc.).
• Experience with containers and orchestrators like Docker or Kubernetes.
• Experience debugging distributed systems.
• Exceptional communication skills for a deeply async and remote environment.