Founding Engineer | 👨🏻‍💻 AI-Native Ops Infrastructure (backed by Y Combinator, $3M+ ARR, $7M+ raised) jobs in United States
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Legion Health · 1 month ago

Founding Engineer | 👨🏻‍💻 AI-Native Ops Infrastructure (backed by Y Combinator, $3M+ ARR, $7M+ raised)

positionSan Francisco
timeFull-time
remoteOnsite
seniorityEntry, Mid Level
money$130K/yr - $190K/yr

Legion Health is building an AI-native operations layer for mental health care. They are seeking a Founding Engineer to own core backend and agent systems end-to-end, designing and building infrastructure that coordinates human clinicians, support staff, and AI agents.

Home Health CareMental HealthTelehealthWellness
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H1B Sponsorednote

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

Node.jsTypeScriptAWSPostgreSQLMachine learningDeep LearningReinforcement learning (RL)Software ArchitectureNext.jsTailwind

Required

Experience with Node.js
Experience with TypeScript
Experience with PostgreSQL
Experience with Amazon Web Services (AWS)
Experience with event-driven backend architecture
Ability to design schemas, invariants, and workflows
Experience in building LLM agents
Ability to shape human + AI ops UX
Experience in defining world-state & simulation
Ability to engineer HIPAA-compliant pipelines
Experience in driving architecture & strategy
Ability to own real systems 0→1 or 1→N
Ability to think in events, state, and invariants
Strong understanding of velocity and correctness
Ability to work in small, high-candor teams
Desire to see work go live in production weekly

Preferred

Experience with Supabase
Experience with LLMs
Experience with agents, tool-calling, or RAG
Experience in healthcare, fintech, or other regulated / high-stakes domains
Experience in early-stage startups or founding teams

Benefits

Health Insurance: Medical, dental, and vision benefits
Early-Stage Equity: 0.2%–0.8% meaningful early ownership
Additional Perks: In-person retreats, meal stipends, etc.
Time Off: Flexible, unlimited vacation policy
Work Hours: Flexible but demanding because we're literally saving lives
Impact: Work on something that truly matters to millions of patients and families.
Autonomy and Learning: Ownership over your projects with the freedom to set priorities, shape processes, and drive outcomes end-to-end.
Growth Opportunities: As we scale, we envision our top performers from our founding team stepping into expanded roles and joining our executive leadership team.

Company

Legion Health

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Legion Health offers telepsychiatry services that improve mental health access and care.
dateFounded in 2021
location
Austin, Texas, USA
people-size11-50 employees
web-link
https://legionhealth.com

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 Stage
Total Funding
$5.74M
Key Investors
ZD Ventures
2026-01-13Seed
2024-09-15Seed· $5.62M
2021-06-01Pre Seed· $0.12M

Leadership Team

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Yash Patel
Co-Founder & Chief Executive Officer
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Arthur MacWaters
Co-Founder and President
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Recent News

Behavioral Health Business
Legion Health Pivots to Digital AI-Enabled Psychiatry, Raises Over $6M
2024-10-18
Company data provided by crunchbase