Build the Future of Healthcare

About the Role

As our Founding Lead Engineer, you will own the entire technical roadmap for Synaipse. You aren't just building features — you are architecting the foundation of a healthcare transformation engine that automates the full patient journey from intake through reimbursement. You will report directly to the CEO and President, both practicing neurosurgeons.

This is a ground-floor opportunity to shape the technical direction of a company building the comprehensive practice platform for independent healthcare. You'll make decisions on architecture, infrastructure, AI/ML pipelines, and integrations that will define the product for years to come.

What You'll Build

• The core platform architecture — APIs, data layer, authentication, and role-based access for front desk, clinical, and billing workflows
• AI/ML pipelines for ambient clinical documentation, intelligent coding suggestions, and automated prior authorization generation
• Bidirectional EHR integration engine supporting Epic, Cerner, athenahealth, eClinicalWorks, and other major systems via FHIR, HL7, and proprietary APIs
• Real-time data processing for insurance eligibility verification, claims tracking, and denial management automation
• A secure, HIPAA-compliant infrastructure (SOC 2 Type II) built for healthcare from day one

What We're Looking For

• 7+ years of software engineering experience, with at least 2 years in a technical leadership role
• Deep proficiency in Python (FastAPI/Flask) and TypeScript/Node.js
• Production experience with LLM orchestration (LangChain, LlamaIndex, or similar), vector databases, and RAG architectures
• Strong understanding of React/Next.js for frontend systems
• Experience designing and consuming healthcare interoperability standards (FHIR, HL7 v2, X12 EDI) is a significant plus
• Comfort operating as both architect and hands-on builder in a fast-moving startup environment

Compensation & Benefits

• Competitive base salary commensurate with experience
• Founding equity stake (1–5%) — you're building something that's yours
• Health, dental, and vision insurance
• Remote-first with optional hybrid at 1819 Innovation Hub, Cincinnati
• Direct line to physician co-founders and clinical end-users

About the Role

Your mission is to build the Command Center — the high-velocity React interface that powers every daily workflow at Synaipse. You'll create the unified workspace where front desk staff manage intake, clinicians review AI-generated notes, and billing teams handle the entire revenue cycle — all without leaving a single browser tab.

This is the interface that replaces toggling between 4-6 applications per patient case. Every pixel, every interaction, every millisecond of latency matters. You'll work directly with physician end-users to ship features that eliminate hours of administrative work daily.

What You'll Build

• Role-based workspaces — purpose-built views for front desk (scheduling, eligibility, referrals), clinical staff (ambient scribing, note review, orders), and billing (coding, PA, claims, denials)
• A real-time dashboard consolidating patient journey status, authorization tracking, and revenue cycle KPIs in one view
• High-performance document handling — PDF rendering, fax image processing, and inline annotation for clinical documentation review
• AI-powered UI components: confidence-scored coding suggestions, auto-populated form fields from referral data, and smart search across patient records
• Accessible, responsive design that works seamlessly across desktop and tablet for clinical environments

What We're Looking For

• 5+ years of frontend engineering experience with React and TypeScript
• Proven track record building complex, data-dense interfaces — think dashboards, workflow tools, or enterprise SaaS
• Deep understanding of state management (Redux, Zustand, or similar), performance optimization, and component architecture
• Experience with Canvas API, PDF.js, or similar document rendering technologies is a strong plus
• Eye for design and UX — ability to translate requirements into clean, intuitive interfaces without detailed mockups
• Comfort working in a fast-paced startup where you'll ship features measured in days, not sprints

Compensation & Benefits

• Competitive base salary commensurate with experience
• Significant founding equity stake — own what you build
• Health, dental, and vision insurance
• Hybrid work from 1819 Innovation Hub, Cincinnati with flexible remote days
• Direct access to physician co-founders and real clinical users for rapid feedback loops