Founding Engineer - 👨🏻‍💻 AI-Native Mental Health Care (backed by Y Combinator, $3.3M+ ARR, $7M+ raised)

Benefits

Additional Information

🧠 About Legion Health Legion Health (backed by Y Combinator) is building autonomous mental healthcare -AI that takes real responsibility across the full care loop: before the visit, during the visit, and after the visit . We run our own psychiatric practice, which means we ship into reality -not theory. We're rebuilding the patient experience end-to-end: Outside the visit: scheduling, intake, benefits checks, paperwork, reminders, care coordination, billing, risk detection, follow-ups, and patient messaging Inside the visit: visit support, real-time note scaffolding, structured history capture, differential reasoning support, diagnostic signal extraction, treatment planning assistance, medication decision support, and clinician workflows that make great care feel effortless Not "doctor-in-a-box." Not a layer of prompts. We're building AI teammates that clinicians can trust-agents that do the work, show their reasoning, handle edge cases, and escalate cleanly when humans need to step in. Our agent system already supports 2,200+ patients with a tiny team. The systems you build go straight into production and show up in patient outcomes, clinician velocity, and the quality of care-immediately. Legion exists to make mental healthcare fast, affordable, and excellent at scale . This role is one of the highest-leverage ways to get there: you'll help turn clinical judgment into reliable systems , and turn AI from a tool into a true operator -so patients get sharper care and clinicians get their time back. 🚀 Role: Founding Engineer - AI-Native Mental Health Care (In-Person in SF) Hey-I'm Daniel Wilson , co-founder & CTO at Legion. I studied applied math + CS at Princeton, then led the Office Scripts + Power Automate integration at Microsoft-shipping the highest retention-driving feature in the product. Before that, I did deep learning + RL research. I'm obsessed with building AI systems that make real workflows cleaner, safer, and more autonomous. Github: https://github.com/danielgwilson I'm hiring a Founding Engineer to own core product + agent systems end-to-end . You'll build the layer that coordinates patients, clinicians, and AI agents as one coherent machine-tight feedback loops, high standards, and real ownership. This isn't "just infra." It's building the product heart of an autonomous care system: the workflows, the agent behaviors, the guardrails, the integrations, the UX that makes it usable, and the reliability that makes it trusted. Roles evolve quickly here-including mine. I'm looking for someone who wants to carry real weight , take full ownership, and grow into running major parts of the system-not someone who needs a perfectly scoped box to operate inside. ✅ What You'll Do Own our event-driven backend - Architect and scale our Node.js / TypeScript / Supabase (Postgres) / AWS stack. Design schemas, invariants, and workflows that encode how psychiatric care actually operates. Turn messy real-world processes into clean state machines and event streams. Build real LLM agents as coworkers - Implement tool use, retries, memory, and safety rails. Design action schemas and evaluation loops so agents can run reliably in production. Work on orchestration, context management, and multi-step workflows. Shape human + AI ops UX - Build internal tools used by both humans and agents. Make it trivial to see "what happened, why, and what should happen next" in any patient journey. Define world-state & simulation - Model the canonical state of a patient's journey across time. Power alerting, routing, and decision-making from that live simulation. Own data, safety & compliance - Engineer HIPAA-compliant pipelines for transcripts, events, and EHR data. Ensure PHI access, agent actions, and human overrides are all auditable. Drive architecture & strategy - Work directly with me to debate tradeoffs, define new primitives, and decide what we build next. You don't need to be a pure backend engineer-we value great product engineers who can learn fast , make strong simplifying decisions, and grow into owning backend/agent systems. 🏆 You Might be a Fit If... You've owned real systems 0→1 or 1→N , not just tickets. You think in events, state, and invariants , not just CRUD endpoints. You're either already LLM-fluent or a strong systems/backend engineer who can get dangerous fast. You care about velocity and correctness-moving quickly while keeping things understandable and robust. You like small, high-candor teams and direct feedback. You want to see your work go live in production weekly , not sit on a roadmap. 🧰 Nice to Have Experience with Node.js / TypeScript, Postgres, or Supabase. Experience with LLMs, agents, tool-calling, or RAG. Experience in healthcare, fintech, or other regulated / high-stakes domains. Experience in early-stage startups or founding teams. 💻 Our Tech Stack Backend: Node.js, TypeScript, Supabase (Postgres), AWS (ECS, Lambda, S3) Frontend: Next.js 15 (App Router), Tailwind, Ve

Your Match

How well this role fits your profile.

Company Intel

What employees say

Worked at legionhealth? Share your experience