Founding Software Engineer — Tracy Health

Compensation: 3.0% – 10.0%

Tracy Health is building a patient-controlled health record and EHR co-pilot that helps patients, clinicians, and caseworkers work together, using AI as a tool, not a replacement. We’re focused on the people healthcare software most often fails: high-mortality states, limited care access, unhoused individuals, people living with substance use disorders, and people in behavioral health crisis. That includes a field tool for street teams and caseworkers, who do some of the hardest care work there is with some of the worst software.

We’re early, but not starting from zero: we have a live FHIR-integrated prototype, 40 customer discovery interviews with patients, caregivers, clinicians, and enterprise stakeholders, and advisors.

We’re looking for an early engineer who may have lived in the messy reality of healthcare software. You should know why a “simple” feature can take six months in a regulated environment, and still be able to ship fast.

You’ll be one of our first engineers, with real ownership over what we build and how we build it.

What you’ll do

• Take products from a blank repo to something real patients, providers, and caseworkers depend on
• Build the record-unification layer: pulling fragmented data from multiple sources into one patient-controlled view via FHIR and our existing integrations.
• Design field-ready tools for street teams, which means mobile-first, resilient to poor connectivity, and built for fast, high-stakes moments.
• Build consent and access controls that reflect real life: patients deciding what caregivers, clinicians, and caseworkers can see, with granularity rather than all-or-nothing.
• Translate clinical and regulatory requirements into technical decisions, from data models to audit logging to deployment topology.
• Shape the infrastructure healthcare uniquely demands: auth, audit trails, BAAs, PHI handling, and consent management.
• Own our path through HIPAA controls, SOC 2 Type II, and 42 CFR Part 2. Substance use data is core to our product, not an edge case.
• Help make privacy legible to patients, not just compliant. Many of the people we serve have good reasons to distrust systems that hold their data.
• Raise the bar on how we use AI in our own development (agentic coding, evals, internal tooling) without compromising the rigor that regulated software requires.

What we’re looking for

• Healthcare depth. You’ve shipped software inside the medical industry and understand its intricacies: EHR integrations, clinical workflows, payer dynamics, or wherever your specialty lies. You can tell us why healthcare software is hard in ways outsiders miss.
• Interoperability experience. Hands-on work with HL7 FHIR and the practical realities of pulling usable data out of real-world health systems.
• 0→1 instincts. You’re energized by ambiguity. You’ve built products from nothing and know when to ship duct tape and when to build it right.
• End-to-end SDLC fluency. Requirements, design, implementation, testing, deployment, monitoring, incident response. You’ve worked across all of it.
• Language-agnostic. You’re comfortable in multiple languages, with deep expertise in at least one of TypeScript/JavaScript, Python, Java, Kotlin, or similar.
• A learner. New frameworks, new regulations, new clinical domains: you pick them up fast and don’t need handholding.
• Agentic coding in your workflow. You’ve already made agentic tools (Claude Code, Cursor, etc.) part of how you build. You treat them as a serious force multiplier rather than a novelty, and you have opinions on where they help and where they hurt.
• Comfort in regulated environments. You can read a regulatory requirement and design a technical control that satisfies it without crushing velocity. You treat compliance as a design constraint, not a blocker.
• Direct experience with: HIPAA (administrative, physical, and technical safeguards), SOC 2 (you’ve been through an audit, ideally Type II), 42 CFR Part 2 for SUD data, and the broader landscape of patient confidentiality.
• Mission alignment. You care about building for people the healthcare system routinely leaves behind, and you’ll design with them, not just for them.

Nice to have

• Prior founding-engineer or very-early-stage experience
• Experience building for public health, social services, or street medicine, such as HMIS, community resource directories, or case management systems
• Mobile or offline-first development experience
• HITRUST, GDPR, or state-level privacy law experience (CMIA, NY SHIELD, etc.)
• Experience with x12 or other healthcare interoperability standards beyond FHIR