Full-Stack Engineer (Healthcare)

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
Intro call (30 min): meet the founding team, learn about Clara's mission
Technical screen (60 min): a full-stack pairing problem, leveled to the seat
Onsite (4 hours): system design, code pairing, team fit
Reference checks and offer

Experience
1+ years

Work arrangement
No