Senior / Staff Founding Engineer

View all jobs Senior / Staff Founding Engineer New York Engineering In office Full-time About Rovi Health Rovi is an AI-powered care concierge and virtual clinic for employer health plans. We monitor clinical data in real time, catch expensive care before it gets scheduled, and redirect members to higher-quality, lower-cost options. When someone has a condition we can treat directly, we do that through our own virtual clinic.

The problem we’re solving: in-network prices for the same procedure vary up to 10x within a single zip code. A hospital MRI costs $3,000. The independent imaging center ten minutes away charges $500. Same scan, same quality. But nobody tells the patient, the doctor doesn’t know the price, and the employer won’t see the claim for months. So the expensive option wins by default, every time. Rovi changes that.

We deliver high-quality care to member before they choose the expensive or low-quality default. Our AI-native clinic allows us to treat and navigate care, meaning we can reduce outpatient spend by over 30% while improving health outcomes. We’re live with 30,000 patients today and adding thousands more each month. We’re backed by Y Combinator, Lightspeed, Gradient (Google’s AI fund), Liquid 2 (Joe Montana), and others.

The Role You’ll own entire product surfaces, end to end. Talk to a customer, understand the problem, decide what to build, architect the solution, write the code, ship it, and measure whether it actually moved the needle. You have full authority over your areas and direct access to the founders. As part of the founding team, the systems you build become the foundation that everything else runs on.

You’ll make bets that change the company’s direction and set the engineering culture that every future hire inherits. What You’ll Own The platform Rovi isn’t one product. Members interact through text. Clinicians treat patients asynchronously. AI agents orchestrate care in the background. Employers see their savings in real time. All of this has to work together. You’ll own the architecture that ties it together: the event-driven agent framework, shared memory across patient interactions, tool orchestration, the APIs that connect everything.

Early intervention systems We have access to claims data, clinical records, and live patient interactions. Someone is heading toward a $50K surgery that could happen at an outpatient center for $15K. A member missed a follow-up that’s going to turn into an ER visit. An out-of-network referral is about to cost the plan $8,000 more than it should. You’ll build the systems that catch these things and trigger the right response.

The virtual clinic We’re building a virtual clinic that delivers care at a fraction of what it costs in a traditional setting. AI handles intake and triage. Human clinicians focus on the parts that need a human. One provider can handle 10x the volume because the system does the work that used to eat their day. You’ll design the technical systems that make this possible and keep improving as we scale.

Scale We serve thousands of members today. That number is going to grow by orders of magnitude. The real-time responsiveness that makes early intervention work has to survive that growth. You’ll make the architecture calls that let us move fast now without building something that falls over later. Who We’re Looking For - 8+ years building software. Deep in Python, React, and TypeScript. - You’ve owned products end to end.

Not “built features on a roadmap someone else wrote” but actually owned the thing, from the user conversation to the shipped product to measuring whether it worked. - You’ve built and run production systems where the stakes were real. Healthcare or fintech experience is a plus. - You’ve shipped AI/ML in production. Agent systems, LLM orchestration, data-heavy pipelines. - You’d rather have ownership and ambiguity than a well-defined lane and a PM handing you tickets.

Compensation & Benefits - $250K–$320K base + 0.75%–1.5% equity - Unlimited PTO - Daily meals in the office - Wellness stipend You don't need healthcare experience. We care about systems thinking, execution speed, and building things that work. Ready to apply? Powered by First name \* Last name \* Email \* LinkedIn URL \* Resume \* Click to upload or drag and drop here This position is in-person in New York City, 4 days a week.

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