Founding Principal Engineer

We’re helping a venture-backed healthcare technology company find a Founding Principal Engineer to help shape the future of pediatric mental health care. Following a recent Series B funding round, the company is building its in-house engineering team and looking for a hands-on technical leader who can work directly with the CEO, own critical product architecture, and establish the technical foundation for its next stage of growth.

This is a unique opportunity to join a mission-driven organization at a pivotal stage, combining technical ownership, product decision-making, and the opportunity to make a meaningful impact on children's access to mental health care.

About the role

We are seeking a Founding Principal Engineer with 6–15 years of full-stack engineering experience to work directly with the CEO and establish the technical foundation for a pediatric mental health platform that's rebuilding care from the ground up.

This is a high-impact opportunity for a hands-on, product-minded engineer who thrives in early-stage environments, takes ownership of complex consumer products, and makes independent technical and product decisions in a regulated industry.

Following a recent Series B funding round, the company is transitioning from an offshore engineering team to a small, exceptional in-house engineering organization. You'll play a critical role in shaping the platform's architecture, engineering standards, and future team.

Responsibilities

• Own technical architecture and implementation: Write production code on the most challenging technical problems while designing and maintaining systems across telehealth, electronic health records (EHR), patient dashboards, and AI-powered capabilities.
• Partner directly with the CEO: Translate clinical, growth, and operational needs into technical solutions and make independent product decisions without relying on detailed product requirements documents.
• Lead engineering execution: Guide the transition from the offshore engineering team while establishing engineering standards, code review processes, and quality practices.
• Drive AI adoption: Identify and implement opportunities to leverage AI to accelerate development and enhance product capabilities.
• Build the engineering organization: Help establish a high-caliber in-house engineering team over the next 6–12 months.
• Make pragmatic technical decisions: Balance speed, scalability, reliability, security, and maintainability in a fast-moving environment.
• Shape the product: Take end-to-end ownership of features and systems, from understanding user needs to deployment and iteration.

Requirements

• Required Qualifications
• 6–15 years of professional full-stack engineering experience.
• Recent experience as a founding engineer or one of the first five engineers at a venture-backed startup. Big Tech experience is welcome when combined with early-stage startup experience.
• Strong, hands-on experience building and shipping production applications using TypeScript, Node.js, React, and AWS.
• Experience operating at the Staff or Principal individual-contributor level, with ownership of systems from architecture through production.
• Experience building software in regulated environments, such as healthcare or fintech, with an understanding of security, privacy, and compliance requirements.
• Strong product instincts and the ability to make thoughtful UX, feature, and technical decisions without detailed specifications.
• Ability to work independently, navigate ambiguity, and deliver high-quality solutions in an early-stage environment.
• Genuine interest in improving pediatric mental health care and the ability to articulate why this mission is meaningful to you.
• An active GitHub profile or personal project portfolio that demonstrates engineering skills and technical depth.
• Ability to work in a hybrid arrangement with three days per week in the company's Union Square, New York City office.
• Bonus Qualifications
• Experience leading or managing offshore and distributed engineering teams.
• Hands-on experience implementing AI or large language model (LLM) capabilities in production systems.
• Experience integrating telehealth platforms, electronic health records, patient-facing applications, or other healthcare technology systems.
• Familiarity with HIPAA and healthcare data privacy requirements.
• Experience establishing engineering processes, coding standards, testing practices, and deployment workflows from the ground up.
• Experience scaling engineering teams and transitioning from outsourced development to an in-house organization.
• Experience working closely with executive leadership to influence product strategy and technical direction.