Principal Engineer (backed by Y Combinator, $5M+ ARR, $23M+ raised)
Hybrid (San Francisco, CA)$250k - $400kFull-timePosted 1mo ago
About the role
Senior principal-level engineer sought to own multiple end-to-end domains within Legion Health's regulated, AI-driven care platform. Role involves architecting and delivering high-impact, end-to-end systems in a production, HIPAA-conscious environment with heavy use of AI agents.
Responsibilities
- Own real domains including: factory spine, clinical work spine, agent operations in production, data and metrics estate, and architecture syncs with the CTO.
- Ship at high velocity with robust guardrails, audits, and fail-closed defaults; manage 500–1,000 PRs per month with capability to scale to 10,000.
- Own end-to-end architecture across complex systems, ensuring clinical-grade correctness, auditability, and safety in AI-assisted care delivery.
Qualifications
- 10+ years of experience in architecture across multiple companies or large codebases (senior staff+ level)
- Experience shipping high-volume, AI-agent-enabled systems
- Ability to own ambiguous, load-bearing problems end-to-end and document decisions
- Proactive written communication with stakeholders
- Experience in HIPAA-compliant, auditable systems
Skills
Required:Architecture leadershipSystem design for AI-enabled platformsDocumentation and communication
Benefits
- In-person retreats
- Meal stipends
- Health insurance (medical, dental, vision)
- Flexible, unlimited vacation policy
- Partial remote considered for exceptional candidates
- Opportunity to join executive leadership as company scales
Last updated Sep 23, 2026. Interested? Apply on the company site.
About Legion Health
AI-native psychiatry, built for scale and covered by insurance
Legion Health is a high-quality, AI-enabled psychiatry network where patients receive care from a provider who takes their insurance. We use LLMs and AI agents to improve care quality, streamline operations, enhance patient communications, and more.
artificial-intelligenceconsumer-health-servicestelehealthhealthcaremental-health
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