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 achieved $1M+ ARR, raised over $6M, and operates a functioning psychiatric practice with real clinicians and patients.

Requirements:

Candidates must have experience building and owning complex systems from 0 to 1, not just features but foundational elements.
A strong understanding of systems, state machines, and event flows is required, rather than just endpoints.
Candidates should be LLM-fluent or a strong systems engineer eager to become fluent quickly.
A preference for velocity and clean architecture is essential, with the ability to move fast while building resiliently.
Candidates should be comfortable with ambiguity and rapid iteration, and able to handle direct, honest feedback in a high-candor environment.
A high standard for personal and team performance is expected, with a strong desire for direct impact and technical depth.

The role offers the opportunity to shape the engineering culture and core systems of a rapidly growing company in the mental health sector.
Founding engineers will have a direct line to the CTO and influence over future product development.
The position allows for significant impact on real-world operational challenges in mental health care.
There is potential for equity in the company based on strong performance.
The work environment is dynamic, with a small, intense team that ships meaningful features daily.