Description:

The position is for a Founding Full-Stack Engineer at Legion Health, a remote, full-time contractor role with potential for transition to an employee position including equity.
The company is focused on building an AI-native operations layer for psychiatric care, addressing operational challenges rather than diagnostics.
The engineer will work on real-time, AI-powered backend systems for mental health clinics, including scheduling, documentation, billing, and risk detection.
The role involves owning entire domains end-to-end, including architecture, implementation, and iteration, rather than just completing tasks.
Responsibilities include architecting and scaling a Node.js / Next.js / TypeScript / Supabase (Postgres) / AWS stack, building LLM agent infrastructure, shaping human + AI operations UX, defining patient journey simulations, and engineering secure, HIPAA-compliant data pipelines.
The engineer will collaborate directly with the CTO to define system design and strategy, addressing questions at the frontier of AI in healthcare.
The company has a strong foundation with $1M+ ARR, $6M raised, and a functioning psychiatric practice, aiming to solve real-world operational challenges.

Requirements:

Candidates must have experience building and owning complex systems from 0 to 1, focusing on foundational work rather than just features.
A strong understanding of systems, state machines, and event flows is essential.
Candidates should be LLM-fluent or a strong systems engineer willing to quickly gain fluency in LLMs.
A preference for velocity and clean architecture is necessary, with the ability to move fast while building resilient systems.
Candidates should be comfortable with ambiguity, rapid iteration, and direct feedback in a high-candor environment.
A high standard for personal and team performance is expected, with a rejection of mediocrity.
The ideal candidate should seek direct impact, technical depth, and the opportunity to solve unprecedented problems.

The role offers the chance to be a foundational hire, shaping the engineering culture and core systems of the company.
Employees will have a direct line to the CTO and influence over future product development.
The opportunity to work on meaningful projects that have a real impact on mental health care operations.
The position allows for the potential transition to a full-time employee role with equity based on performance.
Employees will be part of a small, intense team that ships daily, avoiding bureaucracy and dead weight.