Senior Fullstack Engineer, AI Orchestration

At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs. Healthcare carries a $1 trillion administrative burden and we're at the center of transforming it. Today, 500,000+ clinicians across 500+ healthcare organizations nationwide trust Commure to handle $25B+ in annual claims and support over 200 million patient interactions. Our latest $70M raise at a $7B valuation reflects the confidence the market has placed in this mission. We've also been named to the Fortune Future 50 list and the 2026 AI Breakthrough Awards for “Overall NLP Company of the Year.” Our team works directly alongside clinicians, not through layers of process, which means the gap between what you build and its impact on patient care is immediate. We move fast, deploy daily, and take full ownership from early thinking to production. If you're energized by hard problems, high stakes, and a team that holds itself to a high bar, you'll find your people here. The future of healthcare is being built right now. Come deliver this transformation. At Commure, our AI Orchestration team is at the forefront of revolutionizing healthcare technology by building Agents that automate core components of healthcare workflows. We're looking for talented engineers to scale our agent stack to the next level. If you love working on important, exciting problems in healthcare and love shipping quickly, come join us! - Work closely with engineering teams to tackle a wide variety of technical challenges in building efficient and scalable software, delivering quality features and a great customer experience - Lead the design, development, deployment, and iterations of complex features, collaborating with engineers, Product Managers, UX designers, and leadership - Enhance and evolve Commure’s product architecture - Work closely with cross-functional teams to understand customer pain points and identify, prioritize, and implement maintainable solutions - Promote product development best practices, supportability, and code quality, both through leading by example and through mentoring other software engineers - Keep current with emerging industry trends and technology to inform leadership and the Product Team What You Have - B.S., M.S., or Ph.D. in Computer Science or other quantitative fields or related work experience - Experience in shipping enterprise-grade software products - Experience leading complex projects from start to finish and across multiple release cycles, including conceptualization, product integration, deployment, monitoring, and upgrade - Ability to write readable, testable, and supportable code in JavaScript, TypeScript, Node.js (Express) - Experience with LLM applications and RAG tooling (Gemini, GPT, VectorDB etc.) - Ability to collaborate with Product Management to clarify requirements, scope work, and drive product deliverables - Advanced understanding of DevOps practices and technologies (Docker, Kubernetes, CI / CD, release management) - Experience with security tooling in SDLC and Security by Design principles Qualifications (Bonus): - Experience with speech and dialog technologies (ASR, TTS, telephony) - Experience with Image and pdf technologies (OCR etc) - Experience with event driven architecture/technologies (RabbitMQ, Kafka, BullMQ, etc) - Experience with ML and AI training frameworks (PyTorch, TensorFlow, etc.) - Experience with Nodejs build systems (rush, nx, vite, etc.) - Experience with Public Clouds - AWS, GCP or Azure - Experience in health tech - Experience working at a startup Please be aware that all official communication from us will come exclusively from email addresses ending in @commure.com http://commure.com. Any emails from other domains are not affiliated with our organization. Employees will act in accordance with the organization’s information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. Employees will be required to attest to these requirements upon hire and on an annual basis.