Founding Engineer

About Wedge Wedge helps healthcare organizations deploy and scale AI employees. We're live across hundreds of clinical locations, supporting more than two million patients nationwide. We're looking for exceptional folks to join our team as we keep up with surging demand. About the role Wedge is hiring founding engineers to build our platform side by side with the founding team in San Francisco. This isn't a role with a narrow lane. You'll own entire systems — the agent runtime, the evaluation infrastructure, the integrations that connect us to hospital systems of record — and make the architectural calls that every engineer we hire after you will inherit. The work is unusually consequential. Our agents run real back-office operations inside health systems, which means the code you ship this week is handling records, scheduling, and claims for real patients shortly after. Reliability is a product requirement here, not a nice-to-have, and you'll build the guardrails that make agent autonomy safe inside a regulated environment. Founding engineers set the bar at Wedge: for code quality, for velocity, and for what we expect from the team we build around you. What You'll Do Own core systems end to end — architecture, implementation, deployment, on-call, and iteration. Build the agent platform: orchestration, tool use, prompt pipelines, and the evaluation infrastructure that keeps agents reliable inside hospitals.

Design the integrations where healthcare actually lives: EHRs, clearinghouses, payer systems, and the messy interfaces in between.

Set technical direction. Make the calls on architecture, tooling, and tradeoffs, and write the standards the team follows.

Work directly with customers. Sit with hospital operations teams, watch the workflows you're automating, and bring what you learn back into the product.

Raise the bar on hiring — interview, mentor, and help build the engineering org around you. Qualifications Experience building production software, with a track record of systems you owned rather than tickets you closed. Exceptional engineers with less experience should still apply.

Deep proficiency in TypeScript and/or Python, and enough range across the stack to ship a full feature without waiting on anyone.

You've shipped LLM-based or agentic systems to real users, and you have opinions about why they break.

Thrives in complexity and ambiguity, prioritizing collaboration and seeking the best ideas regardless of their source.

A strong bias toward ownership. You see the gap, you fill it, and you tell the team afterward. Bonus Early-stage experience: one of the first engineers at a startup, or a company you founded yourself.

Familiarity with healthcare data and standards: EHRs, FHIR/HL7, X12, RCM workflows.

Infrastructure depth: cloud platforms (Azure, GCP, AWS), Docker, Kubernetes, observability.

Shipping under compliance constraints: HIPAA, SOC 2, and audit-friendly system design.

Open-source contributions, hackathon wins, or side projects people use.