About the role
What we're looking for
We need a senior- to staff-level backend or systems engineer with at least 4 years of experience. 6–7 years is ideal, roughly graduating in 2018–2019. You should have built and run reliable, scalable production systems at a fast-growing startup or a top tech company. You should be comfortable owning modules end to end in a fast, in-person team with little hand-holding, and you should already build with AI coding tools like Claude Code and Codex every day. Bonus points if you've built AI agents in production or come from a top engineering school or a company like Meta, Palantir, Sierra, Decagon, Perplexity or ElevenLabs.
What you'll do:
- Design and build the platform modules that run operations for the largest outpatient healthcare enterprises, covering scheduling, patient communication, insurance, accounts payable, reconciliation, credentialing and reporting
- Own a product line or vertical from design through build, deployment and operation, and drive reliability, security and lower error rates as Arini adds hundreds of clinic locations
- Work closely with forward deployed engineers, customer success and the CTO/co-founder (Rami) to turn one-off customer solutions into reusable products. For example, you might take the EHR-to-bank reconciliation demo and turn it into a product that works for many enterprises
- Build and operate AI agents in production, with the evaluation, guardrails, observability and client feedback loops that tune them automatically. This is applied agent work, not model training or research
- Lead infrastructure projects from scoping to rollout, such as tools that let non-technical team members configure custom modules for clients
- Design and improve data models, pipelines and integrations into practice management, billing, payment and vendor systems (including ones without APIs), and own on-call and root-cause analysis for what you build
About Arini
Arini is building the single platform to run all healthcare operations.
Healthcare has spent the last decade consolidating, but operations are still fragmented, manual, and expensive. A large group runs dozens of disconnected systems for scheduling, billing, insurance, payables, and reporting, with people moving data between them by phone, fax, and spreadsheet.
We partner with some of the largest healthcare enterprises in the country through a Forward Deployed Engineering model. Engineers sit with the customer, find their biggest operational problems, and ship systems that solve them end to end. The best of that work becomes the platform that scales across enterprises.
Our goal is to deliver the operating leverage healthcare consolidation has promised for decades, so providers can focus on patient care. We obsess over improving patient outcomes, and we are building the platform to run all operations for a $620B industry.
We move extremely fast and take extreme ownership. Humans only do what AI can't, and that includes us.
Backed by Y Combinator (W24).
Required skills
Other roles at Arini
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Job details
Salary
$190,000 - $250,000
Equity
0.1% - 0.5%
Location
San Francisco, United States
Experience
4+ years
Funding
Total raised
$500K
Last stage
Seed
Investors
What happens next.
No applications, no recruiter spam. Just the intro.
Confirm the fit
A few questions to make sure this role is the right shape for you. Two minutes.
I pitch you to the company
I write the intro, send it to the founder, and handle the back-and-forth.
A meeting lands on your calendar
If they’re a yes, I book the chat. You show up — that’s the whole job-hunt.