Founding Engineer

WHY THIS ROLE IS DIFFERENT - You build the machine, not just the product. Your job is to make one great advocate do the work of ten. That's the company, not a feature. - Real founder equity and a founding seat. Genuine ownership, upside, and decision rights from day one. - A right to win, not a thesis. Medicare reimburses the coordination seniors' care has always lacked, but almost no one has operationalized it. We have provider pilots launching Q3 2026 and a model that works. - Your code changes patient outcomes. Fragmented care sends seniors to the hospital who never had to go. The software you ship in year one sits between a senior and a preventable crisis. COMPANY DESCRIPTION US older adults do not have a healthcare system that works as one. They move between independent doctors, specialists, pharmacies, hospitals, and insurers that never connect, so no one sees the full picture of their care. As a result, the hardest coordination work falls on patients and families instead of professionals. Families track medications, repeat histories, chase referrals, sort bills, and appeal denials. This leads to fragmented care, unnecessary costs, and avoidable complications. Leland Care https://lelandcare.com creates the coordination the system never provided. We give every senior a dedicated advocate team led by a registered nurse and powered by purpose-built AI. The team manages appointments and follow-ups, reconciles medications across doctors, appeals denied claims, and catches issues early. The right specialist gets the full history in advance. Because Medicare covers Leland Care, most older adults can now get what only the wealthy have long had: a team whose whole job is making their care work. We're launching pilots with providers in Q3 2026, targeting a 25% reduction in avoidable hospitalizations and ED visits. ROLE DESCRIPTION You are the first engineer and a founding partner. You own the product and architecture end to end. You're building the system that makes one nurse advocate as effective as ten: an AI-native operating layer where agents do the admin and humans do the care. The advocate keeps the judgment and the relationship; your software schedules the follow-ups, calls the clinics, chases the pharmacies, checks the portals, preps the notes, summarizes a patient's full history before every call, and surfaces the risks no one else caught. Underneath the agents sits the operating system that makes them possible and compliant: the patient queue, advocate workflow, family communication, records access, time tracking, documentation, audit trail, and reporting. Real PHI, real claims, real stakes, built right the first time. You'll work shoulder-to-shoulder with the advocates using your software every day, watch it fail in the real world, and fix it before lunch. No PM layer, no spec hand-off, no quarter-long architecture review. Ship, watch, fix, ship again. WHAT YOU WILL DO - Build the AI-native advocate platform. Agents that schedule follow-ups, call clinics, chase pharmacies, check portals, prep notes, summarize patient context, and flag risk — each one moving admin off the advocate and onto software. - Ship the operating system underneath it. Patient queue, advocate workflow, communication, records access, task and time tracking, documentation, audit trail, QA dashboard, reporting — the compliant foundation everything compounds on. - Sit with the advocates. Watch the software break, fix it the same day, treat user friction as a P0. - Own architecture, stack, and what's next. No committees. Set the bar on security and compliance early — auditable documentation is how the company gets paid. - Build the team when it's time. Hire the first engineers and grow into Head of Engineering or CTO as the platform widens. WHO YOU ARE - You've personally built and shipped hard software from zero. Not managed it. Built it. - You write code today, and you want to keep writing it for a long time - You have product taste — you take an ugly real-world workflow and make it simple - You've worked close enough to users to know how software fails in the field, and you fix it fast - You can build useful AI workflow automation now, or learn fast enough to close the gap in weeks - You're pragmatic about AI: outcomes over novelty, every time - You're comfortable in a regulated, high-stakes environment (healthcare, CMS, PHI) - Pass if you need a PM, a spec, a big team, a perfect integration, or months of architecture before you ship anything. WHY APPLY NOW The market is there, the model is funded, and the seed round has been raised. Provider pilots launch Q3 2026, and the team that knows how to operationalize them is already in place. What's missing is the software — and the engineer who builds it.