Senior Fullstack Engineer (Ambient AI)

Who is Recruiting from Scratch: Recruiting from Scratch is a premier talent firm that focuses on placing the best product managers, software, and hardware talent at innovative companies. Our team is 100% remote and we work with teams across the United States to help them hire. Senior Fullstack Engineer (Ambient AI) Location: Mountain View, CA / San Francisco, CA / Los Angeles, CA (Hybrid, 3 days/week) OR Remote in New York, NY Company Stage of Funding: Late-stage HealthTech scaleup (Series D, $800M+ raised) Office Type: Hybrid / Remote (NY) Salary: $170,000 - $240,000 + Competitive Equity Visa: Visa sponsorship available (H1B transfers, TN, F1 supported; no net-new H1Bs) Company Description Our client is building AI-native healthcare infrastructure designed to simplify clinical workflows and eliminate administrative burden across healthcare systems. Their platform powers hundreds of care sites, supports over 500,000 clinicians, and processes billions in healthcare transactions annually. This is an opportunity to join one of the fastest-scaling healthcare AI companies and work on their Ambient AI product - helping clinicians reclaim hours lost to documentation through real-time transcription, clinical note generation, and intelligent workflow automation. You'll join a high-growth engineering team solving deeply technical challenges at the intersection of distributed systems, real-time AI processing, and healthcare infrastructure. What You Will Do Design and influence scalable full-stack architecture for AI-powered healthcare workflows Build across the stack using Python, Go, TypeScript, and React Ship production features for ambient clinical documentation systems Work on real-time transcription reliability and large-scale note generation workflows Build integrations with clinical systems and EHR infrastructure Lead technical planning for high-impact product initiatives Drive system design decisions balancing scale, reliability, and usability Partner cross-functionally with product, design, and clinical stakeholders Work directly with customers to solve product issues and improve workflows Mentor engineers and raise engineering quality standards Contribute to deployment, testing, observability, and production excellence Operate effectively in a fast-moving, ambiguity-heavy startup environment Ideal Candidate Background 5-10 years of full-stack engineering experience Experience at fast-growing startup or reputable scale-up environments Strong backend engineering fundamentals with full-stack ownership capability Experience shipping customer-facing production systems at scale Strong proficiency in Python or Go Strong frontend experience with TypeScript and React Experience with distributed systems and cloud infrastructure Hands-on system design experience Experience collaborating directly with customers and stakeholders Ability to own initiatives from ideation through production Preferred / Strong Signals Experience in regulated industries (healthcare, fintech, insurance) Experience building note-taking, transcription, or workflow automation products Experience with real-time systems or streaming architectures AWS / Docker / Kubernetes experience Cross-platform product experience Track record of scaling systems through high-growth phases Technical leadership or mentorship experience Strong startup adaptability Top-tier technical education Strong Signals Thrives in ambiguity and high-velocity engineering environments Strong product ownership mindset Customer empathy and user-centric engineering approach Ability to move quickly without sacrificing quality Comfortable shipping frequently Bias for action Strong communication across technical and non-technical teams Genuine interest in healthcare transformation Compensation and Benefits Base salary: $170,000 - $240,000 Competitive equity Hybrid flexibility (3 days onsite) Remote option in New York Visa sponsorship support Work on one of healthcare AI's highest-growth products Clear growth trajectory in a rapidly scaling engineering org High-impact ownership Why Join This is a chance to work on AI products that solve real, daily pain points for clinicians. You'll help build ambient clinical intelligence systems that directly improve healthcare delivery while solving genuinely hard engineering problems across real-time AI processing, large-scale infrastructure, and product reliability. If you want meaningful technical ownership at a company already operating at serious scale - while still moving with startup speed - this is a rare opportunity.