FOUNDING AI-Native Platform Engineer

"BUILDING THE AI-NATIVE OPERATING SYSTEM FOR HEALTHCARE"

-THE PLATFORM-
DECA is building the AI-native operating system for healthcare organizations and clinics.
We sit above existing practice management and operational software as an intelligent
control plane — connecting fragmented systems, normalizing data, orchestrating AI agents,
and automating workflows across an entire healthcare organization.
The architecture spans cloud infrastructure, local/on-premise systems, real-time data
synchronization, workflow orchestration, and production AI agents.
We are not building another point solution or AI wrapper. We are building the platform layer.

-THE DECA ADVANTAGE-
Most pre-seed startups build in a speculative vacuum. We don’t.
DECA has a built-in live pilot environment across 7 operating healthcare clinics in Texas. The
infrastructure you build won’t sit in a demo environment waiting for product-market
validation — you’ll deploy against real systems, real workflows, real users, and real
operational complexity from day one.
You ship to production from day one.

-THE ROLE
You will be DECA’s Founding Engineer and first engineering hire.
This isn’t a conventional senior engineering role. You’ll have substantial technical ownership
and work directly with the founder to architect the platform every future engineer inherits —
making foundational decisions around distributed systems, data architecture,
synchronization, workflow orchestration, AI-agent infrastructure, security, reliability, and
scale.
There’s no large engineering org to disappear into and no product manager handing you
narrowly defined tickets. We have the product vision, initial architecture, working
foundation, and live pilot environment. We’re looking for the engineer who wants to own the
technical execution.

-WHAT YOU'LL BUILD-
AI Agent Orchestration — Production AI agents using LangGraph/LangChain and LLMs to
reason across scheduling, administrative, financial, patient-engagement, and operational
workflows.
Workflow Infrastructure — Long-running, durable healthcare workflows using Temporal,
including retries, human approvals, failure recovery, and multi-step automation.
AI-Native Data Layer — Healthcare data pipelines combining PostgreSQL, pgvector, and
RAG to give agents reliable context across structured operational data and unstructured
knowledge.
Local Edge Synchronizer — A resilient real-time bridge between DECA’s cloud platform
and on-premise healthcare/practice-management systems, supporting bidirectional sync,
offline operation, reconciliation, retries, and secure data movement.
Multi-Tenant Cloud Platform — Secure AWS infrastructure supporting individual clinics
through large multi-location healthcare organizations.
Command & Integration Infrastructure — A controlled platform layer for executing writes
back into underlying systems with authorization, validation, conflict detection, rate limiting,
auditability, retries, and recovery.

Healthcare Interoperability — Integration spanning legacy databases, APIs, practice-
management software, and standards including HL7 and FHIR.

Security & Compliance Infrastructure — HIPAA-oriented architecture, audit trails, tenant
isolation, access controls, encryption, and infrastructure designed toward SOC 2 readiness.
Provider & Admin Applications — Next.js/React interfaces giving healthcare teams
visibility into workflows, agents, operational data, exceptions, and actions across the
organization.

-WHO YOU ARE-
We’re looking for a senior builder who is unusually strong across backend infrastructure,
distributed systems, and applied AI. Ideally, you have:
5–8+ years of backend, platform, infrastructure, or distributed-systems engineering
experience
2+ years building production LLM, AI-agent, or AI-enabled systems
Deep experience with TypeScript, Node.js, NestJS, and PostgreSQL
Strong Python fluency for AI/ML tooling and services

Experience with LangGraph, LangChain, Temporal, or comparable orchestration
frameworks
Strong understanding of distributed systems, async workflows, queues, retries,
idempotency, and failure recovery
Experience designing multi-tenant SaaS platforms
Experience with AWS and containerized infrastructure
Comfort integrating with legacy systems, third-party APIs, databases, and imperfect
real-world infrastructure
Strong systems-design judgment and the ability to make architectural decisions without
excessive process
A builder mentality: you read the roadmap, identify what needs to exist, architect it, and
ship it
Especially valuable: healthcare technology, HIPAA-regulated infrastructure, HL7/FHIR, SOC

2, local/on-premise-to-cloud synchronization, pgvector/vector databases, RAG, event-
driven or distributed architectures, high-reliability workflow systems, AI-agent

infrastructure, legacy software integrations.
Healthcare experience is valuable, but exceptional platform engineers from other complex
or regulated industries should still apply.
Tech Stack
Backend & Platform: TypeScript, Node.js, NestJS, PostgreSQL, MySQL, Redis, REST APIs
AI & Agent Infrastructure: Python, LangGraph, LangChain, OpenAI API, LLMs, RAG,
pgvector/Vector Databases
Workflow & Distributed Systems: Temporal, Real-Time Synchronization, Distributed
Systems, Event-Driven Architecture
Cloud & Infrastructure: AWS, Docker, Docker Compose, Kubernetes
Frontend: Next.js, React
Healthcare & Security: HIPAA, HL7, FHIR, SOC 2, Multi-Tenant SaaS Architecture

-WHAT YOU GET-
$180K–$280K base salary
1.0%–4.0% founding equity (up to 4.0% for an exceptional, co-founder-adjacent profile)
Milestone based bonuses

4-year vesting, 1-year cliff
Remote-first, deep-work culture
Direct access to the founder — no committees, no bureaucracy
Significant architectural autonomy
A real 7-clinic production environment from day one
The opportunity to become the technical foundation of the engineering org as DECA
scales

-WHY THIS ROLE IS DIFFERENT-
There are plenty of jobs where a senior engineer optimizes an existing service, owns one
component of a mature stack, or bolts AI onto an established product. This isn’t one of
them.
You’ll help determine how an AI-native healthcare platform should actually be built — from
the edge synchronization layer and canonical data architecture through workflow
orchestration, AI agents, command infrastructure, applications, security, and production
deployment. The decisions you make now become the architecture every future DECA
engineer builds on.

If you’re the kind of engineer who’d rather build the system than inherit one, let’s talk.

Thank you.