About the role
Windows Systems Engineer
About Trellis
Trellis builds and deploys computer-use AI agents that get patients access to life-saving medicine. Our agents process billions of dollars worth of therapies a year, automating document intake, prior authorizations, and appeals at scale — classifying medical referrals, understanding chart notes, and automating contract and reimbursement search to give patients accurate coverage determinations and cost responsibility. The result is streamlined operations and faster care for patients in all fifty states.
We're a spinout from the Stanford AI Lab, backed by leading investors including Y Combinator, General Catalyst, and Telesoft Partners, alongside executives at Google and Salesforce.
The Role
We're hiring a Windows Systems Engineer to own the Windows Server and Remote Desktop Services (RDS) infrastructure that powers our fleet of computer-use agents. This is a deeply hands-on systems engineering role: you'll keep the session hosts, service accounts, scheduled tasks, and underlying Windows environments stable, performant, and recoverable — at a scale where downtime has real consequences.
The Scale
The infrastructure you'll own operates at serious scale and directly supports patient care:
- Thousands of computer-use agents running concurrently, 24/7
- 20M+ prescriptions processed every year
- 400 clinics live across all 50 states
- $15B+ in medications dispensed flowing through the systems you keep running
When a session host hangs or an agent stalls, it isn't an abstract SLA breach — it's a clinic waiting on a prescription. Reliability here is the job.
