Staff Platform Engineer
Citizen Health · San Francisco ·
- Work mode
- Hybrid
- Seniority
- Staff
- Category
- Devops
- Experience
- 4+ years
- Visa sponsorship
- Yes
- Company size
- 11-50
Citizen Health · San Francisco ·
We run an agentic AI platform that acts as a personal advocate for rare disease patients. Our AI agent lives in your text messages, makes phone calls, automates browser sessions, maintains persistent memory across months of patient interactions, and coordinates multiple sub-agents to handle everything from appointment preparation to insurance navigation. The infrastructure challenge is unlike anything in traditional SaaS: long-running autonomous agent sessions with unpredictable compute patterns, real-time messaging at scale, tool-use pipelines that touch the open web on behalf of patients, and healthcare-grade compliance requirements across all of it.
We need someone to own this platform end-to-end.
We're hiring a Staff Platform Engineer to build and own the infrastructure that powers Citizen Health — the cloud platform, deployment systems, and reliability practices that let our teams ship AI-driven features safely at speed. You'll partner with teams across AI, web, mobile, and data engineering to keep our platform performant, secure, and compliant with healthcare standards (HIPAA, SOC 2, and adjacent frameworks).
This is a hands-on technical leadership role. You'll write code, set the direction for platform engineering, and raise the bar for how the entire org runs in production. You will likely be the first dedicated infrastructure hire and will build the platform engineering function from the ground up — owning everything from Terraform to on-call until you grow the team.
You'll report to the Director of Engineering.
Platform & infrastructure strategy — Set the technical direction for our agentic platform. Design architectures that handle long-running AI agent sessions, real-time WhatsApp message delivery, and autonomous tool execution (browser, phone, API calls) — all within HIPAA boundaries. Make the right build-vs-buy calls and keep infrastructure cost-efficient as we scale from hundreds to tens of thousands of active patients.
Reliability & observability — Define SLOs, build the observability stack, drive incident response, and keep uptime boringly high. Make on-call sustainable. When something breaks at 2am, you fix it, write the post-mortem, and spend the next sprint making sure it never happens again — without being asked.
CI/CD & developer experience — Own the deployment pipeline end-to-end. Eliminate friction in the inner and outer loops so teams can ship to production dozens of times a day with confidence. Our AI engineers should be thinking about models and prompts, not fighting deploys.
Inference cost & capacity management — AI inference is our largest variable cost. Partner with AI engineering to optimize model serving, manage GPU and compute capacity, negotiate vendor contracts, and make sure our unit economics work as we scale.
Security & compliance — Partner with security and legal to maintain HIPAA, SOC 2, and related regulatory standards. Implement controls that protect patient data without slowing teams down. Secure the agent tool-use pipeline — when our AI agent opens a browser or makes a phone call on behalf of a patient, the blast radius has to be contained.
Cross-functional partnership — Work closely with Product, AI/ML, Data, and Security to translate platform needs into roadmap. Unblock teams and mentor engineers across the org.
You've been the person who saw a scaling wall six months before it became a crisis, made the case to rearchitect, and then did the work. You've led infrastructure through a meaningful inflection — 10x traffic growth, launch into a new channel, migration from monolith to services — and you can talk concretely about what broke, what you learned, and what you'd do differently.
You thrive in early-stage environments where the team is small, the scope is broad, and the best answer hasn't been written in a runbook yet. You default to data, automate the toil, and document what you learn. You've worked at a startup before (ideally sub-50 people) and you liked it.
8+ years of software / infrastructure engineering experience; 4+ years in a senior IC or technical leadership role on a Platform, SRE, or DevOps team.
Deep expertise running production systems on a major cloud provider (AWS, GCP, or Azure).
Hands-on with Kubernetes, infrastructure-as-code (Terraform, Pulumi, or similar), and modern CI/CD tooling (GitHub Actions, ArgoCD, Spinnaker, etc.).
Strong programming skills in at least one of Go, Python, or TypeScript — you build tooling, not just configure it.
Demonstrated experience scaling infrastructure through a significant growth inflection (10x users, new product surface, architectural migration) in a production environment.
Proven track record designing for high availability, zero-downtime releases, and graceful degradation in regulated or data-intensive environments.
Strong security fundamentals: IAM, secrets management, network segmentation, vulnerability management, supply-chain security.
Experience at an early-stage or high-growth startup where you owned infrastructure broadly, not just a narrow slice.
Excellent written and verbal communication — you're equally effective in a post-mortem, a roadmap discussion, and a Slack thread.
Experience supporting AI/ML workloads in production — model serving, inference optimization, GPU infrastructure, vector databases, or large-scale data pipelines. This is close to a must-have given our architecture.
Familiarity with agentic AI systems, multi-agent orchestration, or long-running autonomous workflows.
Experience with messaging infrastructure at scale — message queues, webhook reliability, delivery guarantees, rate limiting (WhatsApp, SMS, or similar).
Background in healthtech, life sciences, fintech, or other regulated domains (HIPAA, SOC 2, HITRUST, FedRAMP).
Familiarity with FHIR / HL7 or other healthcare data standards.
Experience growing a Platform or SRE function from a small group of generalists into a specialized team.
Citizen Health was founded on the belief — shaped by firsthand lived experiences navigating healthcare — that having the right advocate is the single most important factor in achieving better care and outcomes. By uniquely combining data, AI, and community, Citizen is building a personalized AI advocate powered by patients' complete medical histories and data from thousands of other patients to generate personalized insights for clinical decisions and day-to-day challenges. Starting in rare and complex conditions, patients share their data in exchange for value, enabling biopharma and researchers with seamless access to patients and regulatory-grade data, shaving years off drug development for much-needed treatments.
Citizen is founded by experienced entrepreneurs with multiple successes under their belts and is funded by top-tier investors including 8VC, Transformation Capital, and Headline Ventures, among others. We are a mission-driven team excited to be building the future of consumer healthcare.
The chance to build platform infrastructure for an agentic AI system that doesn't exist anywhere else — the playbook hasn't been written yet.
A real mission with real patients. The people using our product are navigating rare diseases with their children. The infrastructure you build directly affects whether they get the right diagnosis, the right benefits, the right clinical trial.
Ownership from day one. You'll shape the platform engineering function, not inherit someone else's architecture.
A fast-paced, high-growth setting with expanding opportunities and clear paths for career progression.
A supportive culture of learning, experimentation, and innovation, where new ideas are encouraged and explored.
Competitive salary + equity
Comprehensive health, dental, and vision insurance
Unlimited PTO, including 12 weeks paid parental leave
Flexible remote-first work environment
Work-from-anywhere 30 days per year
Company offsites
Our Commitment to Diversity & Inclusion: Citizen Health is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We welcome applicants of all backgrounds, identities, and experiences — regardless of race, gender identity, sexual orientation, religion, national origin, age, disability, or veteran status.
Don't meet every qualification? We believe that passion, curiosity, and the right mindset matter as much as a checklist of skills. If you're excited about what we're building, we encourage you to apply.