Preface Health — Founding Engineer

Type: Full-time | On-site | San Francisco, CA Compensation: $180,000–$230,000 + 0.25%–1.5% equity Hiring count: 1 Visa sponsorship: None available — must be authorized to work in the U.S. without sponsorship Reports to: Anurag, Co-founder & CTO (technical co-founder)

About Preface Health

Preface Health is building AI referral infrastructure for healthcare, helping patients get from a primary or urgent care visit to the right specialist quickly and seamlessly. The platform is deployed across 75+ urgent care locations and is piloting with a top-three U.S. health system, with deep EMR integration work underpinning the product. A team of three moving fast in a market that has long lacked a coordinated referral layer.

Founded: 2024 | Team size: 1–10 (pre-seed) | Total funding: $2.5M (Maveron, 1984, Commonweal) Industry: Healthcare Website: Office: San Francisco, CA

Why Candidates Should Join

• True founding ownership: First engineering hire, owning the full technical surface alongside the technical co-founder from day one, with real say over architecture and product.
• Real traction already: Deployed across 75+ urgent care locations and piloting with a top-three U.S. health system.
• Strong backing & founder access: $2.5M from Maveron, 1984, and Commonweal; direct, daily access to both co-founders.

Intake Call Summary

• No intake-call transcript was included on the role page. An intake video is posted but not transcribed here — share the transcript and I'll fold a summary in.

The Role

Preface Health's first engineer — a full-stack founding hire who owns the entire technical surface alongside the technical co-founder, building and shipping across front end, back end, and cloud while contributing to product thinking as the company scales its urgent-care and health-system network.

What You'll Be Doing

• Own the full technical stack — front end, back end, and cloud infrastructure — building and shipping across all layers.
• Design and ship EMR integrations connecting the referral platform to urgent care, ER, and specialist workflows.
• Build and iterate on the core referral flow so patients get routed to the right specialist quickly and reliably.
• Contribute to product decisions alongside the co-founders, translating clinical and operational needs into engineering priorities.
• Establish engineering foundations, patterns, and practices as the first engineering hire.

Tech stack: Python backend, front end, cloud infrastructure; EMR integrations / healthcare data standards.

Requirements

• 3 to 5 years full-stack engineering experience (candidates under 3 years who demonstrate exceptional ability will be considered; candidates over 7 years are generally outside the target range)
• Strong Python, front end, and cloud across the stack
• Zero-to-one product ownership experience
• U.S.-based undergraduate degree required
• In-person, five days a week, startup hours
• Authorized to work in the U.S. without visa sponsorship
• Healthcare or EMR integration experience a strong plus

Green Flags

• Healthcare startup background
• Zero-to-one product ownership
• Strong academic and professional spike

Red Flags

• Short tenure across multiple recent roles
• Open to work signal on LinkedIn
• Tech-stack inflation in LinkedIn bio
• Non-U.S.-based undergraduate degree
• Contractor-only work history

Role Details

• Salary — $180,000–$230,000
• Equity — 0.25%–1.5% (top-line Job Details field shows 0%–1% — see flag)
• On-site policy — In-person, 5 days/week, startup hours (~9am–9pm)
• Visa sponsorship — None available
• Employment type — Full-time
• Location — San Francisco, CA

Benefits: meals provided in office.

Screening Questions

• None specified on the role page. If the Contrario form adds screening questions, share them and I'll incorporate them here.

Interview Process

Stage 1 — Pending Approval — Candidates awaiting initial approval. Stage 2 — Intro call with Anurag, Co-founder & CTO (15 min) — Initial get-to-know and technical screen. Stage 3 — Call with Geoffrey, Co-founder & CEO (15–30 min) — Culture fit and behavioral assessment. Stage 4 — Technical interview — Deeper technical evaluation. Stage 5 — Final round — Conversation with Geoffrey (CEO), or both co-founders together; all stages conducted online. Stage 6 — Offer Extended Stage 7 — Candidate Hired — Candidate accepts and starts.

Ideal Companies & Backgrounds

Updated Jul 31, 2026 Healthcare startups — Commure, Notable (named as example backgrounds in the role's nice-to-haves) Technical-bar signal — Top-tier university paired with strong early-career engineering work, or a competitive engineering-focused employer.