Senior Cloud Engineer - AI-Powered Clinical Workflows

Transform Healthcare Through Technology

Own and ship AI‑powered clinical workflows on Azure—both as the program orchestrator and as a hands‑on full‑stack engineer. If you thrive at the intersection of engineering, AI, product, and people—and can turn complex systems into reliable, observable, and cost‑efficient production workflows while writing production code daily—this role fits.

About Zenara Health

Founder‑led US health‑tech startup creating AI‑powered clinical software clinicians love. We combine cutting‑edge technology with deep healthcare expertise to solve real problems for real clinicians. Our culture values builders who ship, leaders who serve, and teams that deliver through clear communication and collaboration.

Why This Role Is Different

You lead and you build. You run cross‑functional solution sessions, structuring flows‑as‑code, and jumping in to write the critical integration that unblocks delivery. You standardize how we design, implement, and operate AI workflows on Azure—driving clarity, velocity, and accountability—while retaining the ability to code full time when needed.

You drive solutions through dialogue and execution. You don't just manage tasks—you facilitate focused conversations that end in decisions, then you or your agents/juniors implement them. You get the right people talking, ask the right questions, and maintain momentum with hands‑on delivery.

Your work directly impacts patient care. Every workflow you orchestrate and every feature you ship makes healthcare better for providers and patients.

What Success Looks Like

• First 30 days:
• Establish flows‑as‑code governance (Jira, PR workflows, environments, prompt versioning)
• Ship code and unblock priority MVP items; improve communication and decision hygiene
• First 90 days:
• Operationalize multi‑model workflows (GPT‑4.1/5 + SLMs) with step‑wise model/tool selection
• Stand up telemetry, evaluation, and resilience patterns; automate repetitive developer tasks
• First 6 months:
• Act as communication and technical hub; mentor engineers on agentic best practices, structured generation, tool‑calling, and orchestration
• Mature governance so sprints consistently produce decisions and outcomes; hire and calibrate high‑leverage contributors
  
  

Core Responsibilities

Builder (hands‑on; :60%)

• Write production code daily across the stack (TypeScript/React, Python/Node.js), owning services/modules end‑to‑end
• Implement and optimize backend services and Azure workflows (Azure Functions Durable, Azure Container Apps)
• Operationalize RAG pipelines: ingestion (Azure Blob/ADLS Gen2), indexing (Azure AI Search), embeddings/retrieval strategies
• Standardize tool‑calling (MCP) for EHR/EMR, scheduling/communications, internal knowledge APIs; mix remote and custom‑hosted tools
• Build practical test harnesses, quality gates, and evaluation suites; drive performance, reliability, and cost efficiency
• DevOps as needed: CI/CD (GitHub Actions), IaC (Bicep/Terraform preferred), observability (App Insights/Monitor/OpenTelemetry), SRE‑minded ownership
  
  

Orchestrator (program ownership; :30%)

• Translate product vision into executable roadmaps; facilitate planning aligning architecture, delivery, and QA
• Operate a GA‑ready Azure stack for orchestration, retries, and scaling (Functions Durable, Container Apps, Queues/Event Grid, KEDA)
• Implement resilience patterns: idempotency, retry/backoff, dead‑letter queues, rate‑limit handling, circuit breakers
• Generalized performance management:
• Interactive experiences feel responsive via streaming and efficient tool calls/RAG
• Batch workflows run predictably with clear SLAs, timeouts, and automated retries
• Concurrency scales horizontally with autoscaling/backpressure; cost is instrumented and optimized regularly
• Governance and vendor boundaries:
• Maintain Jira/Confluence hygiene; enforce PR‑based workflows, environments, versioned prompts
• Drive vendor deliverables to avoid IP leakage; document decisions and architecture changes
  

Communicator (alignment; :10%)

• Facilitate focused problem‑solving conversations that surface blockers and end in decisions
• Bridge technical and business stakeholders with clear, jargon‑free communication across time zones
• Create psychological safety so issues surface early; run async‑friendly rituals; contribute to hiring calibration (scorecards, structured interviews, portfolio/tests)
  
  

Who Thrives Here

Builder, bridge, and catalyst—high‑speed executor ("velvet hammer") who codes at staff level, orchestrates agentic workflows, and keeps teams aligned. You make order from ambiguity, convert difficult conversations into outcomes, and leave teams more aligned than you found them.

Technical Requirements

• 4-8 years mixing hands‑on development with technical leadership/TPM experience; ability to code full time when needed
• Fluent in modern web/services stack: TypeScript/React, Python/Node.js; REST/gRPC; async jobs and streaming outputs
• Azure‑first experience:
• Orchestration: Azure Functions Durable, Azure Container Apps, Queues/Event Grid, KEDA
• Data: Azure Blob/ADLS Gen2, Azure AI Search (vector), SQL/CosmosDB, Redis
• Observability: App Insights, Azure Monitor, OpenTelemetry; evaluation and guardrails for AI steps
• AI/ML familiarity:
• Multi‑model orchestration (GPT‑4.1/5 + SLMs like LLaMA/Nous) with step‑wise selection guided by latency/cost tradeoffs
• RAG pipelines; embeddings; retrieval strategies; structured generation and tool‑calling/MCP
• Tools and workflow:
• Daily user of AI assistants and automation tools
• Excellence in Jira, Confluence, Git workflows; strong async remote communication (US shift)
  
  

Healthcare And Regulatory (preferred)

• Exposure to healthcare data models (e.g., FHIR) and regulated environments
• Security/compliance awareness (HIPAA, SOC 2/HITRUST a plus); audit readiness platforms (e.g., Vanta) beneficial
  
  

Communication Requirements

• Facilitate technical design sessions that reach consensus and decisions
• Translate between technical and business stakeholders effectively
• Resolve conflicts constructively; write clear, durable documentation
• Run meetings that produce decisions, not just discussions
  
  

Intangibles We Value

• Proactive communication that catches dropped balls early
• Documentation that makes complex topics simple
• Trust‑building across technical and non‑technical teams
• Steady under pressure; bold when shipping; pragmatic and outcome‑driven
• Sees ambiguity and conflict as opportunities for better solutions
  
  

Major Advantages

• Healthcare technology or regulated industry experience
• Architecture reviews/technical decision facilitation; flows‑as‑code governance
• Stories of aligning misaligned teams and improving delivery velocity
• Cross‑cultural communication; vendor management with strong IP discipline
  
  

Compensation & Benefits

• Competitive compensation: ₹14,00,000 - ₹28,00,000 per year
• 100% remote — work from anywhere in India; US shift
• Direct mentorship from technical leadership; equity potential for exceptional performers
• Health insurance; professional development support
• Internet reimbursement; work from home
• Supplemental pay: joining bonus, performance bonus, yearly bonus
  
  

How To Apply

Important: Applications must be submitted through our website to be considered.

Submit your application and attach a link to your work/ portfolio/ a video introducing yourself

Process

• Profile match → interview invitation within 48 hours
• 20-25 minute AI screening at your convenience
• Top candidates progress to technical team discussions
• Exceptional candidates may complete the process within :10 days. Note: Check spam folders—invitations sometimes land there. Indeed‑only applications cannot be processed
  
  

Job Types: Full‑time, Permanent, Contractual/Temporary

Work Location: Remote