Founding Software Engineer — Healthcare Platform

Compensation: $180k – $260k • 1.0% – 4.0%

Founding AI-Native Platform Engineer

$180k – $260k • 1.0% – 4.0%

"BUILDING THE AI-NATIVE OPERATING SYSTEM FOR HEALTHCARE"

-THE PLATFORM- DECA is building the AI-native operating system for healthcare organizations and clinics. We sit above existing practice management and operational software as an intelligent control plane — connecting fragmented systems, normalizing data, orchestrating AI agents, and automating workflows across an entire healthcare organization. The architecture spans cloud infrastructure, local/on-premise systems, real-time data synchronization, workflow orchestration, and production AI agents. We are not building another point solution or AI wrapper. We are building the platform layer.

-THE DECA ADVANTAGE- Most pre-seed startups build in a speculative vacuum. We don’t. DECA has a built-in live pilot environment across 7 operating healthcare clinics in Texas. The infrastructure you build won’t sit in a demo environment waiting for product-market validation — you’ll deploy against real systems, real workflows, real users, and real operational complexity from day one. You ship to production from day one.

-THE ROLE- You will be DECA’s Founding Engineer and first engineering hire. This isn’t a conventional senior engineering role. You’ll have substantial technical ownership and work directly with the founder to architect the platform every future engineer inherits — making foundational decisions around distributed systems, data architecture, synchronization, workflow orchestration, AI-agent infrastructure, security, reliability, and scale. There’s no large engineering org to disappear into and no product manager handing you narrowly defined tickets. We have the product vision, initial architecture, working foundation, and live pilot environment. We’re looking for the engineer who wants to own the technical execution.

-WHAT YOU'LL BUILD- AI Agent Orchestration — Production AI agents using LangGraph/LangChain and LLMs to reason across scheduling, administrative, financial, patient-engagement, and operational workflows. Workflow Infrastructure — Long-running, durable healthcare workflows using Temporal, including retries, human approvals, failure recovery, and multi-step automation. AI-Native Data Layer — Healthcare data pipelines combining PostgreSQL, pgvector, and RAG to give agents reliable context across structured operational data and unstructured knowledge. Local Edge Synchronizer — A resilient real-time bridge between DECA’s cloud platform and on-premise healthcare/practice-management systems, supporting bidirectional sync, offline operation, reconciliation, retries, and secure data movement. Multi-Tenant Cloud Platform — Secure AWS infrastructure supporting individual clinics through large multi-location healthcare organizations. Command & Integration Infrastructure — A controlled platform layer for executing writes back into underlying systems with authorization, validation, conflict detection, rate limiting, auditability, retries, and recovery. Healthcare Interoperability — Integration spanning legacy databases, APIs, practice- management software, and standards including HL7 and FHIR. Security & Compliance Infrastructure — HIPAA-oriented architecture, audit trails, tenant isolation, access controls, encryption, and infrastructure designed toward SOC 2 readiness. Provider & Admin Applications — Next.js/React interfaces giving healthcare teams visibility into workflows, agents, operational data, exceptions, and actions across the organization.

-WHO YOU ARE- We’re looking for a senior builder who is unusually strong across backend infrastructure, distributed systems, and applied AI. Ideally, you have: 5–8+ years of backend, platform, infrastructure, or distributed-systems engineering experience 2+ years building production LLM, AI-agent, or AI-enabled systems Deep experience with TypeScript, Node.js, NestJS, and PostgreSQL Strong Python fluency for AI/ML tooling and services. Experience with LangGraph, LangChain, Temporal, or comparable orchestration frameworks Strong understanding of distributed systems, async workflows, queues, retries, idempotency, and failure recovery Experience designing multi-tenant SaaS platforms Experience with AWS and containerized infrastructure Comfort integrating with legacy systems, third-party APIs, databases, and imperfect real-world infrastructure Strong systems-design judgment and the ability to make architectural decisions without excessive process A builder mentality: you read the roadmap, identify what needs to exist, architect it, and ship it Especially valuable: healthcare technology, HIPAA-regulated infrastructure, HL7/FHIR, SOC2, local/on-premise-to-cloud synchronization, pgvector/vector databases, RAG, event- driven or distributed architectures, high-reliability workflow systems, AI-agent infrastructure, legacy software integrations. Healthcare experience is valuable, but exceptional platform engineers from other complex or regulated industries should still apply. Tech Stack Backend & Platform: TypeScript, Node.js, NestJS, PostgreSQL, MySQL, Redis, REST APIs AI & Agent Infrastructure: Python, LangGraph, LangChain, OpenAI API, LLMs, RAG, pgvector/Vector Databases Workflow & Distributed Systems: Temporal, Real-Time Synchronization, Distributed Systems, Event-Driven Architecture Cloud & Infrastructure: AWS, Docker, Docker Compose, Kubernetes Frontend: Next.js, React Healthcare & Security: HIPAA, HL7, FHIR, SOC 2, Multi-Tenant SaaS Architecture

-WHAT YOU GET- $180K–$260K base salary 1.0%–4.0% founding equity (up to 4.0% for an exceptional, co-founder-adjacent profile) Milestone based bonuses 4-year vesting, 1-year cliff Remote-first, deep-work culture Direct access to the founder — no committees, no bureaucracy Significant architectural autonomy A real 7-clinic production environment from day one The opportunity to become the technical foundation of the engineering org as DECA scales

-WHY THIS ROLE IS DIFFERENT- There are plenty of jobs where a senior engineer optimizes an existing service, owns one component of a mature stack, or bolts AI onto an established product. This isn’t one of them. You’ll help determine how an AI-native healthcare platform should actually be built — from the edge synchronization layer and canonical data architecture through workflow orchestration, AI agents, command infrastructure, applications, security, and production deployment. The decisions you make now become the architecture every future DECA engineer builds on.

If you’re the kind of engineer who’d rather build the system than inherit one, let’s talk.

Thank you.