Legion Health · 1 month ago
Founding Engineer | AI-Native Ops Infrastructure
San Francisco
Full-time
Onsite
Mid, Senior Level
$130K/yr - $180K/yrLegion Health is building the AI-native operations layer for psychiatric care, focusing on improving the backend processes of mental health services. The Founding Engineer will be responsible for designing and building the infrastructure that integrates human clinicians, support staff, and AI agents into a cohesive system.
Home Health CareMental HealthTelehealthWellness
Responsibilities
Own our event-driven backend – Architect and scale our Node.js / TypeScript / Supabase (Postgres) / AWS stack. Design schemas, invariants, and workflows that encode how psychiatric care actually operates. Turn messy real-world processes into clean state machines and event streams
Build real LLM agents as coworkers – Implement tool use, retries, memory, and safety rails. Design action schemas and evaluation loops so agents can run reliably in production. Work on orchestration, context management, and multi-step workflows
Shape human + AI ops UX – Build internal tools used by both humans and agents. Make it trivial to see 'what happened, why, and what should happen next' in any patient journey
Define world-state & simulation – Model the canonical state of a patient’s journey across time. Power alerting, routing, and decision-making from that live simulation
Own data, safety & compliance – Engineer HIPAA-compliant pipelines for transcripts, events, and EHR data. Ensure PHI access, agent actions, and human overrides are all auditable
Drive architecture & strategy – Work directly with me to debate tradeoffs, define new primitives, and decide what we build next
Qualification
Required
Own our event-driven backend – Architect and scale our Node.js / TypeScript / Supabase (Postgres) / AWS stack
Design schemas, invariants, and workflows that encode how psychiatric care actually operates
Turn messy real-world processes into clean state machines and event streams
Build real LLM agents as coworkers – Implement tool use, retries, memory, and safety rails
Design action schemas and evaluation loops so agents can run reliably in production
Work on orchestration, context management, and multi-step workflows
Shape human + AI ops UX – Build internal tools used by both humans and agents
Make it trivial to see 'what happened, why, and what should happen next' in any patient journey
Define world-state & simulation – Model the canonical state of a patient's journey across time
Power alerting, routing, and decision-making from that live simulation
Own data, safety & compliance – Engineer HIPAA-compliant pipelines for transcripts, events, and EHR data
Ensure PHI access, agent actions, and human overrides are all auditable
Drive architecture & strategy – Work directly with me to debate tradeoffs, define new primitives, and decide what we build next
You've owned real systems 0→1 or 1→N, not just tickets
You think in events, state, and invariants, not just CRUD endpoints
You're either already LLM-fluent or a strong systems/backend engineer who can get dangerous fast
You care about velocity and correctness—moving quickly while keeping things understandable and robust
You like small, high-candor teams and direct feedback
You want to see your work go live in production weekly, not sit on a roadmap
Preferred
Experience with Node.js / TypeScript, Postgres, or Supabase
Experience with LLMs, agents, tool-calling, or RAG
Experience in healthcare, fintech, or other regulated / high-stakes domains
Experience in early-stage startups or founding teams
Benefits
Equity: 0.2%–0.8% meaningful early ownership
Company
Legion Health
Legion Health offers telepsychiatry services that improve mental health access and care.
Founded in 2021
11-50 employees
H1B Sponsorship
Legion Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (1)
Funding
Current Stage
Early StageTotal Funding
$5.74MKey Investors
ZD Ventures
2026-01-13Seed
2024-09-15Seed· $5.62M
2021-06-01Pre Seed· $0.12M
Leadership Team
Yash Patel
Co-Founder & Chief Executive Officer
A
Arthur MacWaters
Co-Founder and President
Recent News
Behavioral Health Business
2024-10-18
Company data provided by crunchbase