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True Talent Solutions Partners

Founding Engineer

New York
Salary
$210,000 - $260,000 annually
Level
Mid
Work type
On-site · New York
Visa
Not offered

Open. First seen 25 October 2026.

Apply on the company's site →

About the role

About the Role

Join an early-stage healthtech team as a backend-leaning Founding Engineer. You will own core platform engineering, building reliable systems for medication pricing, claims, and payments where correctness and uptime directly affect people's access to medication.

What You'll Do

  • Own the backend, including APIs, database design, permissions, sensitive-data boundaries, backups, staging, observability, and deployments.
  • Build and operate a real-time medication pricing system that gathers prices from multiple sources and routes claims to cost-effective options.
  • Manage eligibility and claims workflows connected to an adjudication engine.
  • Build a claims adjudication engine and validate it against the existing system using replayed claims.
  • Develop and operate payment infrastructure connecting brokers and pharmacies, with stringent reliability requirements.
  • Make foundational architecture and schema decisions to support growth from hundreds to tens of thousands of users and beyond.

What We're Looking For

  • Three to eight years of backend or full-stack engineering experience, with strong backend, architecture, and database schema design skills.
  • Experience owning production systems where errors or downtime have a direct financial or operational impact, such as payments, ledgers, trading, or critical infrastructure.
  • Proficiency with Python, FastAPI, PostgreSQL, row-level security, GCP, Cloud Run, Cloud SQL, React, and TypeScript.
  • Experience using AI development tools such as Claude Code or Cursor.
  • Comfort operating as a sole engineer in an early-stage startup, making architecture decisions, and constructively challenging technical direction.
  • Startup experience alongside experience in larger technology organizations is valued. Experience in fintech or infrastructure is a plus.
  • Strong computer science fundamentals are valued. Experience outside healthcare, health benefits, and pharmacy is required.

Compensation & Benefits

Base salary: $210,000 to $260,000 USD annually. Visa sponsorship is not available.

Location

On-site in New York, United States.

What this role asks for

Particular to this role

FastAPI · GCP · PostgreSQL · SQL

Rare in True Talent Solutions Partners's other 122 open postings.

Standard for software engineering roles

Python

Common in software engineering postings at any company.

Compared with True Talent Solutions Partners's other open jobs.

The team: Client Roles

This role is one of 121 open in Client Roles. 121 were posted in the last 30 days, including 6 lead roles: the team is hiring the people who run it too.

WHAT THE TEAM WORKS WITH, ACROSS ITS POSTINGS

Python (65 of 121), LLM (48 of 121), TypeScript (47 of 121), React (38 of 121), Machine Learning (31 of 121), AWS (27 of 121), JavaScript (27 of 121)

OTHER ROLES ON THIS TEAM

From the team and dates on True Talent Solutions Partners's own job board.

Other openings for this role

4 open postings for this role in New York, first posted 25 October 2026. The company is likely hiring for more than one position. None has been taken down and posted again.

Salary context

102 other open postings titled Founding Engineer state a salary: median USD 150,000 to USD 250,000 a year.

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