Staff Software Engineer (Applied AI)

The Opportunity

This is a high-leverage opportunity to serve as a foundational technical leader and full-stack executor, architecting and building the core LLM intelligence layer for the Pearl platform. You will define and implement advanced AI architecture (e.g., RAG or Agentic systems) that scales capabilities across our entire product suite. Your technical vision will ensure our systems are inherently scalable and reliable, directly supporting our mission of driving success in value-based care and transforming primary care delivery.

Who We Are

Pearl Health is dedicated to empowering primary care providers, health systems, and physician-led networks to succeed in the shift to value-based care. Our platform delivers the technology, financial tools, and expert services that enable practices to provide more proactive, effective care to their Medicare patients, ultimately lowering costs and improving health outcomes.

Founded in 2020, we are a team of healthcare and technology innovators backed by premier investors like Andreessen Horowitz, Viking Global Investors, and AlleyCorp. We partner with thousands of providers across 44 states to build a more sustainable future for American healthcare.

What You'll Do

Applied AI and Full-Stack Excellence

• Architect and build the foundational LLM architecture (RAG, Agents, Vector DBs) that powers high-impact product features across the organization.

• Design and deliver high-performance, distributed systems (data pipelines, APIs, microservices) that process healthcare data at scale and securely integrate LLM outputs into the user experience.

• Drive Proof-of-Concepts (POCs) and technical evaluation of new AI technologies to validate their product viability and scalability.

• Design and build responsive web applications using modern frontend frameworks to deliver intuitive, user-facing intelligence and analytic features.

• Ensure observability, monitoring, and operational excellence, championing security and regulatory compliance (HIPAA, SOC2).

Strategy & Influence

• Drive system design and technical planning for all critical projects, including large, complex, and cross-functional initiatives across the organization.

• Partner strategically with Product, Operations, and Design leadership, translating complex business requirements into technical strategies and influencing roadmap prioritization.

• Mentor engineers at Software Engineer I, II, and III levels, accelerating their technical growth and leadership development

• Educate the organization on the capabilities, best practices, and limitations of using LLMs and applied AI within the healthcare domain.

• Define and implement engineering standards, patterns, and best practices that significantly improve scalability, reliability, and developer productivity across the product.

• Conduct thorough design and code reviews, raising the bar for technical quality and sharing knowledge generously across teams

Delivery & Impact

• Own and drive multi-quarter technical projects with autonomy and accountability, ensuring successful delivery aligned with business timelines

• Identify and resolve systemic issues, technical bottlenecks, and cross-team dependencies that impact delivery velocity or system reliability

• Balance speed and quality, making pragmatic decisions that enable rapid iteration while maintaining engineering excellence

• Measure and communicate the business impact of technical work, connecting engineering outcomes to customer value and organizational goals

What You’ll Bring

We are looking for a seasoned technologist who can seamlessly balance deep technical execution with strategic, organizational leadership. Your experience should reflect a proven ability to lead large-scale projects, elevate team performance, and make technology decisions that directly drive business and healthcare outcomes.

Must-Haves

• 8-12 years of experience in large-scale software engineering, with a proven track record in service-oriented architectures and large data systems.

• Demonstrated architectural experience designing and implementing highly observable, scalable distributed systems, including complex microservices and event-driven architectures.

• Hands-on experience in the full-stack productization of Applied AI/LLM features, specifically working with RAG architectures (chunking strategies, semantic search, vector databases) and Agentic workflows.

• Cloud platform proficiency (preferably AWS), including hands-on experience with infrastructure design, deployment pipelines, and cost optimization.

• Expertise in designing and optimizing data-intensive applications, including deep database expertise (schema design, query optimization) and data consistency patterns.

• A strong leadership track record in driving technical direction for significant, cross-functional projects.

Nice-to-Haves:

• Hands-on experience building and deploying robust, user-facing client applications using modern frameworks (e.g., React, Angular, Vue.js, TypeScript).

• Experience building systems in healthcare technology or other highly regulated industries, with an understanding of compliance requirements (e.g., HIPAA, SOC2).

This role might not be for you if:

• You are seeking a role primarily focused on individual contribution without the desire to mentor or influence the growth of multiple engineers.

• You prefer working on projects with a purely short-term focus rather than driving complex, multi-quarter technical projects with long-term organizational impact.

• Your career preference is to specialize deeply in only one area of the stack (pure frontend or pure backend) and not apply expertise across a full-stack context.

• You are primarily interested in academic AI research or fundamental model training, rather than the hands-on productization and deployment of AI features.

Our Values

🤝 Collaborate to Innovate: We believe the best solutions arise from intelligent teamwork. We trust the expertise of our teammates and pursue opportunities to learn and grow from each other. By embracing diverse perspectives and encouraging authenticity, we create and evangelize groundbreaking health solutions.

🗣️ Trust Through Transparency: We prioritize transparency in all our interactions, ensuring that employees, patients, clinicians and partners have access to the information they need to make informed decisions. Integrity is at the core of how we operate, from building products to fostering relationships, and is crucial to our ability to communicate openly and gain trust.

❤️ Serious Impact, Big Heart: We go above and beyond with our efforts to empower proactive, patient-centered care — and we celebrate every step forward. Humor and positivity fuel our creativity, strengthen relationships, and remind us to acknowledge the journey as much as the destination.

We are an Equal Opportunity Employer on a mission to improve lives. Our strength comes from the diverse backgrounds, experiences, and perspectives of our team. We welcome all candidates and are committed to a fair, inclusive hiring process free from discrimination.

What We Offer

The expected offer for this role includes the following components:

• Base Salary Range: $180,000 - $240,000 per year.

• Additional Compensation: This role is eligible for a discretionary performance bonus and equity options.

• Benefits: We offer a competitive benefits package. More on our careers page.

Final compensation for this role will be determined by a variety of factors, including a candidate's relevant skills, experience, labor market conditions, and location.

Agency Submissions

We are not currently working with contingency search firms. If a resume is submitted to any Pearl Health employee by a third party without a valid written and signed search agreement, it will become the property of Pearl Health and no fee will be paid, irrespective of whether the candidate is hired.

The Interview Process

While steps may vary by role, you can typically expect:

1. Recruiter Screen: An intro call to discuss your background and motivations.

2. Technical Exercise: An online assessment meant to evaluate relevant technical skills.

3. Engineering Manager Interview: A deeper-dive conversation with an EM.

4. Panel Interview: A round of technical and behavioral meetings with teammates, a cross-functional partner, and a leader.

5. Executive Interview: Final conversation(s) with 1-2 of our leaders.