- Job title
- Full-Stack Engineer (Healthcare)
- Job location
- San Francisco, CA, US
- Job description
- Clara is building the first AI-first medical practice from the ground up. Unlike most health AI startups, we deliver actual care: our clinicians write prescriptions, order labs and manage patients, supervised by human providers who review every medical decision. Clara's founders built and scaled Circle Medical to over $100M in revenue, and we are funded by Y Combinator and top investors.
This is a mission-driven, high-performance team working in person in San Francisco five days a week. We will assist with relocation and work visas for the right candidate.
## What you'll build
You'll own product surfaces end to end: the patient app, the clinician-facing EHR, the API underneath them, and the seams where our LLM agent meets a real person. A typical month touches a React screen a patient sees, the Django endpoint behind it, the Celery job that follows up, the Amplitude event that tells us whether it worked, and the review queue a nurse practitioner uses to approve what the AI proposed. You'll write the code, ship it, wire the events, read the results and fix what they tell you.
## Your responsibilities
**Product engineering (60%)**
- Ship features across the patient app, staff EHR, and backend (React + TypeScript front end, Django on PostgreSQL)
- Build the surfaces where the AI agent meets people: streaming chat, tool-call results, clinician review and approval flows
- Design onboarding that gets patients to first real value fast, then to habitual use
- Own the mobile shell (Capacitor, iOS and Android) alongside the web app
- Instrument what you ship (Amplitude) and read the results, so the next iteration is driven by what patients and clinicians actually did
**Platform and integrations (40%)**
- Own integrations with the services a medical practice runs on: Stripe, Twilio, medical-records APIs, Customer.io, identity verification
- Model clinical data in PostgreSQL so the product and the AI can reason over it
- Keep the system observable and safe: Sentry, Datadog, audit trails, HIPAA-conscious data handling
- Continuous integration and delivery; improve the developer loop (Tilt, mise, hk) as you go
- Build the internal tooling and background jobs that keep a medical practice running between patient visits
## How we level this role
One posting, two seats. We decide the level from what you have shipped, not from the title on your last business card.
| Level | Typical profile | What we expect on day one |
| ----- | --------------- | ------------------------- |
| **Software Engineer** | 2+ years, has shipped React + TypeScript and a typed backend to real users | Ships well-scoped features end to end with review; learns the clinical domain fast |
| **Senior Engineer** | 5+ years, has owned a product area in production | Owns a domain (EHR, onboarding, integrations) end to end; makes and defends architecture calls; early hires grow into engineering management as the team scales |
Compensation tracks the level: **$130K – $210K base · 0.10% 0.40% equity · health insurance and standard benefits.**
## What we're looking for
**Required at every level:**
- React + TypeScript in production, with users you can name
- A typed backend language in production; Python preferred, Django a plus
- Relational data modelling and SQL; you have designed a schema and lived with it
- You have shipped, owned the result, and can tell a story about something that broke and what you changed
- AI-native: you use Claude, Cursor or similar every day and can say what it is bad at
- Care about correctness and safety in a domain where mistakes reach patients
**Additionally at Senior:**
- Owned a product domain end to end, including the on-call and the roadmap
- Led a migration or re-architecture in a live system without breaking it for users
- Raised the bar for the engineers around you: reviews, patterns, mentoring
**Nice to have:**
- Healthcare or HIPAA experience; FHIR familiarity
- Django / Django Ninja, Celery, PostgreSQL JSONB
- Capacitor or native mobile
- Product analytics and experimentation (Amplitude or similar)
- LLMs as a production tool: content, creative, internal tooling, or building on top of an agent
## What Clara offers
- Ship code that affects real patient health outcomes, and talk to real patients and providers regularly
- Make architectural decisions for an AI-first medical practice, working directly with the founders and CTO
- Ownership of entire domains (product, platform, integrations), and a path into engineering management as the team scales
- In-person collaboration in San Francisco, five days a week; no bureaucracy, ship fast
## About the interview
1. Intro call (30 min): meet the founding team, learn about Clara's mission
2. Technical screen (60 min): a full-stack pairing problem, leveled to the seat
3. Onsite (4 hours): system design, code pairing, team fit
4. Reference checks and offer
