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Principal Software Engineer

foundationhealthcareersUnited States - RemoteEngineering
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Salary
Not listed
Job type
Full-time
Work mode
Remote
Experience
Senior
Posted
9 Oct 2026
Status
Open · checked 7d ago

About this role

This remote role suits an experienced engineer with a background in building production systems and LLMs who wants to tackle complex healthcare challenges. Foundation Health in the United States seeks a Principal Software Engineer to design scalable platforms and develop safe AI agents for specialty pharmacy operations.

Role Overview

Foundation Health operates a live production platform within major US health systems that utilizes AI for patient communication and EHR workflows. The Principal Software Engineer will drive architectural design, mentor engineering teams, and collaborate directly with leadership to scale the platform safely.

Key Responsibilities

Own system architecture across multiple product areas to support significant platform growth.
Build and code the initial versions of complex company problems.
Develop agentic AI solutions, including voice and SMS agents, supported by evaluations, guardrails, and safety measures.
Handle electronic health record integrations, such as Epic queues and prior authorization automation.
Direct AI engineering methodologies, focusing on model selection, latency, cost, and context management.

Requirements

Experience operating at a Staff level or equivalent with a track record of foundational architectural decisions.
Demonstrated background building production-grade LLM applications involving agents, tool use, and safety guardrails.
Experience working in environments where mistakes carry high costs, such as healthcare, fintech, or fraud prevention.
Preference for candidates located in Eastern or Central time zones to overlap with existing team members.

Skills and Tools

LLMs
Postgres
Epic

About the Company

Foundation Health is an AI operating system for specialty pharmacy, employing around 70 people. The company has secured a $20M Series A funding round led by Define Ventures and maintains a remote-first work environment across the United States alongside an engineering hub in downtown Orlando.

How to Apply

Candidates should apply directly on the official company careers page.

Skills and tech stack

Questions candidates ask

Where is the position located?

The role is remote-first across the United States, with a preference for candidates in the Eastern or Central time zones, and includes occasional visits to an engineering hub in downtown Orlando.

What level of experience is required?

The role requires someone who has worked at a Staff+ level with a history of building serious production systems and LLM applications.

Is healthcare experience mandatory?

Healthcare experience is not strictly required, though candidates must have worked in environments where mistakes are expensive, such as fintech or fraud prevention.

What technologies and systems does the engineering team interact with?

The team works with LLMs, Postgres databases, and integrates directly into Epic workflows.

Ready to apply?

The application is on the official foundationhealthcareers careers page.

Apply on company site