TL;DR
Legion Health, a YC S21-backed startup running its own psychiatric practice, is hiring a founding engineer to build the AI-native operations layer that coordinates clinicians, support staff, and LLM agents. The San Francisco, on-site role offers $130K–$190K base, 0.2%–0.8% equity, visa sponsorship, and immediate start.
What happened
Legion Health posted a founding-engineer opening to own and scale the company’s AI-native operations infrastructure. The hire will lead backend and agent systems for the startup’s psychiatric practice, working on an event-driven Node.js/TypeScript stack with Supabase (Postgres) and AWS. Responsibilities include designing schemas and state machines that model patient journeys, implementing LLM agents with tool use and safety rails, building human-and-agent-facing operational UX, and engineering HIPAA-compliant data and audit pipelines. The company says its agent infrastructure already supports more than 2,000 patients with a single human support lead. The role is full-time and in-person in San Francisco; Legion advertises a fast hiring cycle (estimated 7–10 days), a practical take-home exercise and onsite final interview, and lists a salary range of $130K–$190K plus 0.2%–0.8% equity and standard benefits.
Why it matters
- Work on infrastructure that integrates AI agents directly into live clinical workflows, potentially changing how non-visit care is handled.
- Building reliable orchestration, safety, and audit trails is central to deploying AI in regulated healthcare settings.
- A role like this can materially affect clinician time and operational cost by automating scheduling, intake, documentation and coordination.
- Early engineering decisions will influence product behavior at scale for thousands of patients and clinicians.
Key facts
- Company: Legion Health (YC S21); runs its own psychiatric practice.
- Role: Founding Engineer, AI-Native Ops Infrastructure (in-person, San Francisco).
- Compensation: Estimated base salary $130,000–$190,000; equity 0.2%–0.8%; health benefits.
- Tech stack: Node.js, TypeScript, Supabase (Postgres), AWS (ECS, Lambda, S3); frontend Next.js 15 and Tailwind; AI via OpenAI and Anthropic.
- Product scope: event-driven backend, LLM agents, tooling for human+AI workflows, world-state simulation, PHI-safe pipelines and audit trails.
- Scale note: agent infrastructure supports 2,000+ patients with one human support lead, per the posting.
- Hiring process: systems deep-dive (45m), practical work trial (1.5h), final onsite (1.5h); estimated 7–10 day time-to-hire and ASAP start.
- Work setup: on-site at SF HQ; US visa sponsorship available.
- Company funding/metrics: described as $3M+ ARR and $7M+ raised in the job listing.
What to watch next
- How Legion scales its agent infrastructure beyond the cited 2,000+ patients — not confirmed in the source.
- Whether the company secures further funding rounds or extends runway beyond the $7M+ raised — not confirmed in the source.
- Hiring timeline: the company targets a 7–10 day time-to-hire with an ASAP start, so candidate throughput and speed of onboarding are immediate markers to monitor.
Quick glossary
- AI-native operations: Systems designed from the ground up to include AI agents as core components of workflows and decision-making.
- LLM (Large Language Model): A machine learning model trained on large text corpora that can generate or interpret natural language for tasks like summarization, question answering, and tool use.
- Event-driven backend: A system architecture where state changes and workflows are modeled as discrete events and handled asynchronously, often via streams or message queues.
- HIPAA: U.S. federal regulations that set standards for protecting sensitive patient health information.
- Vector DB / embeddings: Data storage and retrieval techniques that use vector representations (embeddings) of text or other data for similarity search and semantic retrieval.
Reader FAQ
Where is the role located?
San Francisco, on-site at the company headquarters.
What is the salary and equity?
Base salary is listed at $130K–$190K, with 0.2%–0.8% early-stage equity.
Does Legion sponsor visas?
Yes. US visa sponsorship is offered, per the listing.
What experience is required on AI and backend systems?
The posting seeks engineers experienced with event-driven systems, backend stacks like Node.js/TypeScript and Postgres, or engineers who can become LLM-fluent quickly.
How fast is the hiring process?
Estimated time-to-hire is 7–10 days with an ASAP start date.
Founding Engineer | AI-Native Ops Infrastructure (backed by Y Combinator, $3M+ ARR, $7M+ raised) Location San Francisco Employment Type Full time Location Type On-site Department Engineering and Product Compensation Estimated…
Sources
- Legion Health (YC S21) Hiring Cracked Founding Eng for AI-Native Ops
- 💻 AI-Native Ops Infrastructure (YC S21, $2M+ ARR, $6.3 …
- Founding Engineer | AI-Native Ops Infrastructure
- AI-Native Ops Infrastructure (backed by Y Combinator …
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