Founding Engineer Healthcare Platform, Stealth Private Equity HealthTech Foundry

Compensation: $180k – $220k • 0.25% – 2.0%

ART 1 — THE POST (full version, for job boards)

Founding Engineer — Healthcare Platform (HIPAA) · Stealth HealthTech Foundry Remote (US) · East Coast hours preferred · Engineer #1, with room to grow into much more

The short version: I'm a Harvard/Yale-trained physician, former PwC partner, former UnitedHealth Group executive, and serial entrepreneur — one of my companies reached multi-unicorn scale. I'm building a new kind of private equity platform for healthcare — not PE-backed, PE reinvented — and I'm hiring engineer #1 to build the platform it runs on.

Why this is different. Most health-tech startups spend their first two years searching for customers. Ours are structural: the model launches with multiple clinical verticals, prototypes already built, and the first vertical already has a marquee anchor partner — among the highest-volume practices in its field — signed on, with 10,000 patients already waitlisted for the next application. The demand side is solved; the constraint is product velocity, and that's the seat you're filling.

What exists already. Working prototypes across the verticals and a real AI layer — predictive models, patient-similarity search, and disease-state simulation — running in a secure, HIPAA-standard cloud environment with reproducible builds and automated tests. Your job is not to extend the AI; your job is to build the production platform underneath it.

What you'll build. One core platform — auth, multi-tenancy, a canonical clinical event store, audit logging, HIPAA infrastructure, model serving — with vertical applications launched on top of it, one specialty at a time. The architecture already anticipates this: everything downstream consumes a canonical event schema, so each new vertical is a configuration and a front-end, not a new codebase.

Where the role goes. This is not a build-one-app job. The company operates as a foundry, spinning up 4–6 companies per year on the shared platform, and the tech organization will grow accordingly. You start as engineer #1 with total technical ownership — you pick the stack, you own the architecture, you hire engineer #2. As the foundry scales, the tech organization expands with it, and scope in that organization is earned, not promised: ambition, drive, trustworthiness, and above all velocity of delivery are what determine how big your role becomes. For someone who consistently ships, the upside is enormous — being #1 in an organization built to keep growing means something different than it does at a single-product startup. No title is guaranteed on day one; the chance to earn a big one is.

Who you are. 7–12+ years, full-stack, and you have personally shipped production systems that handled real PHI, end to end, more than once. You can talk BAAs, audit-log design, AWS HIPAA-eligible services, and SOC 2 from experience rather than from a checklist. You've been engineer #1–3 somewhere before, so you know what it costs and what it pays. You're a pragmatist who works from written specs and acceptance tests. Bonus: FHIR/HL7, EHR integrations, or clinical documentation pipelines.

How we work, and who thrives here. You work directly with the founder — no layers, no committee. We run on daily check-ins and weekly sprints: build, ship, iterate, fast — because the demand already exists and the product has to keep up with it, not the other way around. The clinical and business vision is set and moves fast; you take it and execute relentlessly. We're looking for someone aggressive and ambitious about shipping: delivery over polish debates, dates that hold, momentum as a habit. The division of labor is clean — the founder owns where we're going, you own how it gets built — and people who deliver against that get more scope quickly, because the foundry generates more responsibility than we can staff. Two things are non-negotiable: the highest standard of integrity and honesty (we operate in healthcare, with PHI, under regulators — there is no other way), and caring about the mission. We're not building another point solution; we're out to change how healthcare is understood, advanced, and delivered — globally. If that reads as grandiose to you, this isn't your company. If it reads as the reason to take the #1 seat, keep reading.

Compensation. $25,000/month — a combination of cash and deferred compensation — plus meaningful technical-founder's equity in the core company for the right candidate. The equity is real and earned monthly for the time you put in; there's genuine upside tied to the first funded company, and I'll walk you through exactly how it's structured on our call. As the foundry scales, we structure your permanent package — a higher base, bonus, and equity in the core-asset (platform) company. We're launching three more companies this year, so this is a platform with multiple near-term value events ahead, not a single-outcome bet. If you want a ground-floor lead technology seat in a foundry with captive clinical demand and a founder who has operated at PwC/UnitedHealth scale, let's talk.

Process. 30-minute intro call → technical deep-dive on a HIPAA system you shipped → a paid 3–4 week trial sprint with a real deliverable and written acceptance tests → offer. The sprint is how we both decide; it's how everyone who works with us starts. Full detail on the model, the verticals, and the partners comes under NDA at the deep-dive stage.

Contact: jeff@caremosaics.com — subject line "Founding Engineer," with two paragraphs: the PHI system you're proudest of shipping, and why this stage. Every qualified application gets a reply within 48 hours — we move at the speed we're asking you to.