Lead the design and ownership of core systems for Legion Health’s AI-native healthcare platform, focusing on scalable, event-driven infrastructure for clinical operations, agent orchestration, and data integrity. Own end-to-end domains from problem definition to production deployment, ensuring clinical-grade correctness, auditability, and high-velocity shipping. Drive architectural decisions with autonomy and mentorship for a high-impact, mission-driven team.
Key Highlights
Own entire problem spaces end-to-end, from messy state to documented, production-ready systems with full authority
Architect and scale event-driven TypeScript platform for clinical workflows, agent autonomy, and e-prescribing compliance
Ship 500–1,000+ PRs/month with a lean team, targeting 10,000+ while maintaining clinical-grade rigor and fail-closed safety
Collaborate closely with Co-founder/CTO on architecture syncs, with standing to disagree and drive decisions independently
Work in a regulated environment (e-prescribing controlled substances) with HIPAA-grade security, audit trails, and clinical correctness
Key Responsibilities
Design and own the 'factory spine'—scaling event-driven deployment pipelines from 500–1,000 PRs/month to 10,000+ with canary rollouts and fail-safe mechanisms
Architect the clinical work spine—a production-grade event-sourced system for AI agents and humans to collaborate on patient care with auditability and fail-closed checks
Develop and evolve agent operations infrastructure to safely expand autonomy in clinical workflows, including e-prescribing psychiatric medications
Build and maintain the data/metrics estate (warehouse, analytics pipelines) to track clinical outcomes and system performance with PHI-grade security
Set architectural direction for TypeScript/Node.js-based platform, integrating LLM agents, EHR systems, and e-prescribing workflows
Ensure clinical-grade correctness, HIPAA compliance, and fail-closed defaults across all systems touching patient care
Mentor and collaborate with cross-functional teams (engineering, clinical, ops) to align on system design and priorities
Technical Skills Required
TypeScript
Event-Driven Architecture
Production AI Agent Orchestration
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Benefits & Perks
Medical, dental, and vision benefits
Flexible, unlimited vacation policy
In-person retreats and meal stipends
Nice to Have
Experience with healthcare regulatory compliance (e.g., FDA, DEA, HIPAA)
Deep expertise in distributed systems, microservices, or serverless architectures
Background in reinforcement learning or production ML systems
Familiarity with clinical workflows or psychiatric care delivery
Job Description
Job DescriptionAt , we believe everyone deserves fast, affordable, and world-class health care, and we’re developing the AI infrastructure to deliver it ourselves at world scale.Legion is building (the AI doctor), starting with psychiatry. Our AI-native care-delivery platform currently automates 95% of the administrative work required for us to deliver direct patient care. We also recently became the , allowing us to not only collapse health care’s admin costs but also its clinical labor costs—Our technical moat is hard to copy—we combine , and to deliver measurably better care to a clinically complex patient population. This has helped us produce
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