Founding Full Stack Engineer

About StitchFin:
StitchFin is redefining what’s possible in healthcare operations. Our agentic AI platform powers autonomous agents (including voice AI) that work across revenue cycle tasks, reducing manual burden, easing staff burnout, and reclaiming millions in lost productivity for healthcare providers. We’re building the next generation of automation in healthcare, one capable of transforming how hospitals, large health systems, and RCM vendors communicate with patients and insurance companies every day.

Why now:
Healthcare is facing a massive labor and efficiency crisis. StitchFin’s platform sits at the intersection of AI, automation, and healthcare infrastructure, and we’re scaling fast. Joining our early team means building product foundations that directly shape how providers get paid and how patients experience care.

Role: Full Stack Engineer (Early Engineer / Founding Team Track)

Position Type: Full-time
Location: Remote (USA), must be authorized to work in the US
Start date: ASAP

We’re looking for a Full Stack Engineer with startup grit and product intuition to help design, build, and scale StitchFin’s autonomous AI stack. You’ll work across the full AI agent lifecycle, from voice pipelines to orchestration, real-time analytics, and customer experiences. This is a high-ownership role where your code ships fast, reaches production, and directly improves cash flow for health systems across the country.

What You’ll Do

• Partner closely with founders, design, and customers to turn complex healthcare workflows into simple, high-impact product experiences.
  

• Build the end-to-end agentic AI stack including Voice AI - telephony, speech-to-text, LLM orchestration, text-to-speech, state management, and human-in-the-loop tools.
  

• Integrate with major systems of record (EHRs, RCM tools, call center software) to create seamless, secure, and observable workflows.
  

• Take full ownership of features, architecture, implementation, deployment, and iteration, with a strong focus on stability and speed.
  

• Develop dashboards, configuration tools, and analytics interfaces to manage and tune AI agents in production environments.
  

What We’re Looking For

• Prior startup experience where you shipped meaningful features fast, wore multiple hats, and iterated with customers in real time.
  

• 4+ years of experience building production-grade full stack apps, React, Node.js/Python, PostgreSQL, and modern API design.
  

• Experience with real-time or agentic AI systems, voice AI, telephony integrations, or event-driven architectures.
  

• Deep familiarity with APIs (REST, GraphQL), queuing/event systems, WebSockets, and cloud platforms (AWS or GCP).
  

• Strong product sense, curiosity about users, and a willingness to work directly with non-technical customers teams to shape requirements.
  

Bonus Points

• Experience in healthcare, revenue cycle, or integrating with EHRs and healthcare data standards (HL7, FHIR, X12, EDI).
  

• Background in voice/communication platforms or agent orchestration stacks.
  

• Exposure to SOC 2, HIPAA, or other compliance frameworks for secure data environments.
  

• Experience scaling early-stage SaaS infrastructure, especially in B2B or healthcare automation environments.
  

Why You’ll Love Working Here

• Massive Impact: Build foundational technology in one of healthcare’s most urgent problem spaces.
  

• True Ownership: Work side by side with founders on architecture, design, and strategy decisions — no layers of bureaucracy.
  

• Fast Learning Curve: Touch every part of the stack — AI orchestration, voice systems, and healthcare data pipelines.
  

• Plenty Rewards: Competitive salary, meaningful early-stage equity, and full healthcare benefits (medical, dental, vision).
  

• Momentum: Backed by early adopters, founders, and operators who’ve built companies in healthcare AI, automation, and RCM before.