
Director of Engineering
San Francisco, CAFull-time$250–350K/yrSeen todayStill listed today
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At a glance
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Job overview
Trellis AI is hiring a Director of Engineering to lead a 15-person engineering organization as it scales and doubles headcount. The role reports to the co-founder and CTO and includes setting engineering practices, making technical and organizational decisions, and keeping systems reliable as the company grows. The director will partner with founders, deployments, and go-to-market teams to turn customer needs into a deliverable roadmap.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
TRELLIS BUILDS AND DEPLOYS SELF-IMPROVING AGENTS TO GET PATIENTS ACCESS TO LIFE-SAVING MEDICINE. Our AI agents process billions of dollars worth of therapies annually with patients in all fifty states. We do this by automating document intake, prior authorizations, and appeals at scale to streamline operations and accelerate care. We classify medical referrals, understand chart notes, and automate contract and reimbursement search to provide patients with accurate coverage determinations and cost responsibility. Think of us as the infrastructure behind how patients get their medications. Trellis is a spinout from Stanford AI Lab and is backed by leading investors including YC, General Catalyst, Telesoft Partners, and executives at Google and Salesforce. THE ROLE We went from 6 to 8 figures of revenue in less than a year. Engineering is 15 people today in three pods (platform, deployed, and product), and we want to double the team by the end of the year. We're hiring a Director of Engineering to lead that growth and help us scale from here. The question we're hiring against: what would someone who has taken a company from zero to nine figures in two or three years want to change here? You'll set the engineering bar, make the high-leverage technical and organizational calls, and build a team that ships fast without breaking the things patients depend on. You'll report to Jacky (Co-founder & CTO). WHAT YOU'LL DO
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Scale the team: Hire, onboard, and grow engineers and engineering managers as we double headcount, and set the bar for who we hire
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Set how we build: Own engineering practices, including dev environments, testing, code review, and how we ship, so the team gets faster as it grows
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Make the big technical calls: Drive architecture and vendor decisions across our agent platform, Windows session fleet, and integrations (TypeScript, AWS, Temporal)
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Keep the system reliable: Make sure our infrastructure scales past the $10B of therapies we process today
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Unblock the team: Remove what slows engineers down, and keep platform, deployed, and product pods aligned on what matters most
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Partner across the company: Work with the founders, deployments, and GTM to turn customer needs into a roadmap the team can deliver
ABOUT YOU You're early in a steep career curve: you've grown fast because you're very good, not because you've waited your turn. You've led engineering at an early-stage company that moved quickly, and you still like being close to the code. You want to build the team and the culture, not inherit a process. WHAT YOU'LL BRING
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Experience leading engineering teams at a fast-growing early-stage startup (seed to Series B), ideally through a period of rapid headcount growth
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A strong technical background and credibility with senior engineers; you can still go deep on architecture
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A track record of hiring and developing great engineers
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Experience setting engineering practices that increased speed and quality
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Experience with distributed systems, cloud infrastructure, or AI/agentic products is a plus
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Healthcare experience is a plus
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High ownership, clear communication, and comfort with ambiguity
WHY WORK WITH US
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Real impact at massive scale: We serve patients in all fifty states and are scaling to hundreds of healthcare locations. When the team ships, thousands of patients feel it the next day.
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Incredible growth and traction: We've grown revenue 10x in the past few months alone.
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Work with the founding team: Partner directly with founders and F500 customers, alongside healthcare operations leaders who have overseen 50+ locations.
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Be at the forefront of AI in healthcare: Work on production-grade agentic systems that make critical healthcare decisions, not a demo.
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World-class team: Join teammates who have won international physics olympiads, published economics research, were founding engineers at unicorn startups, and taught AI classes to hundreds of Stanford graduate students.
Compensation & Benefits The salary range above is our good-faith estimate. Your final level and base salary will reflect what you bring: your skills, your experience, and how much ownership you’re ready to take on. Base pay is only one part of the package. Every full-time teammate also gets meaningful equity, because the people building Trellis should share in what it becomes. We are committed to keeping you healthy and supported so you can do the best work of your career. Here are some of the benefits & perks we offer:
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Comprehensive medical, dental, and vision coverage
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Flexible PTO & Sick Time
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Daily meals in the office
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Team offsites
Equal Opportunity at Trellis At Trellis, we’re building AI agents that help patients get life-saving medicine faster. The patients and providers we serve come from every background, and our team should too. Trellis is an Equal Opportunity Employer. We hire based on talent, curiosity, and drive, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic. If you need an accommodation at any point in our hiring process, let your recruiter know and we’ll take care of it.
How this job compares
Set against the 2,287 open Engineering Leadership jobs on Olive Jobs, counted November 12, 2026.
- Pay
- This posting$250–350K/yr
- California median$209–316K/yr268 salary ranges
- US median$182–306K/yr1,905 salary ranges
This range's midpoint, $300K, is 15% above the California median midpoint ($261K) — in the middle half of Engineering Leadership salary ranges in California.
- Openings
- Olive Jobs lists 312 open Engineering Leadership jobs in California and 2,287 across the US. 6% of them nationwide are listed as remote or flexible.
- Experience
- This posting asks for at least 5 years of experience — less than three in four Engineering Leadership postings that state a minimum ask for (median 10 years, across 1,790 postings).
- Education
- 718 of the 2,287 open Engineering Leadership jobs (31%) ask for a bachelor's degree or higher.
Counted across the open, public US postings on Olive Jobs on November 12, 2026. Pay medians are the middle values of the low ends and of the high ends of postings that list both ends of a range in the same cadence (a yearly salary or an hourly rate); a range's midpoint is halfway between its ends. Pay and experience figures resting on fewer than 20 postings are left out.
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