About Us
Axle Health builds AI scheduling and workforce management software to empower in-home healthcare providers to deliver exceptional, personalized care right where patients feel most comfortable—at home.
Some of the biggest providers in the country use our software (like Cityblock Health and U Penn Health System) to improve the utilization of their field teams by 17%+, and automate the operational burden of scheduling and dispatching.
Our platform includes proprietary logistics algorithms to optimize scheduling, a mobile app for field staff, an operations dashboard for office teams, engagement and booking tools for patients, and a wide range of integrations and external APIs for modular access.
We’re a team of top-tier engineers and operators, backed by $14m from top investors such as Y Combinator, Pear VC, and F-Prime, applying our intellect and logistics experience to upend how home healthcare is delivered.
About You
Axle Health is building AI scheduling and workforce management software that powers in-home healthcare delivery for some of the largest providers in the country. As we scale our platform to support hundreds of thousands of patients and expand our enterprise customer base, the reliability, security, and performance of our infrastructure becomes mission-critical; not just technically, but for the patients whose care depends on it.
We're looking for a Senior Engineer, DevOps & Infrastructure to own the foundation that everything else runs on. This is a high-ownership, high-impact role for someone who takes deep pride in the craft of building secure, observable, and scalable cloud infrastructure. You'll be the primary driver of our DevOps maturity, security posture, and HIPAA compliance at the infrastructure layer: working closely with our backend engineers to make sure every system we ship is reliable, hardened, and production-ready. Our ideal candidate is a seasoned infrastructure practitioner who thrives in fast-moving startup environments, brings strong security instincts, and can operate with significant autonomy while staying closely connected to the engineering team's day-to-day work.
We do not monitor YC applications, please apply directly on our website to be considered for this position:
https://www.axlehealth.com/careers
What You’ll Do
Own and evolve Axle's cloud infrastructure on AWS, driving architectural decisions that balance security, scalability, cost, and developer velocity
Design and maintain CI/CD pipelines with integrated security controls including code scanning, secret detection, and dependency vulnerability checks
Lead infrastructure-as-code initiatives using Terraform or equivalent tools, maintaining clean, audited, and well-documented configurations across all environments
Implement and enforce HIPAA-compliant security practices at the infrastructure layer — including PHI encryption, audit logging, BAA management, and access controls
Manage container orchestration (Docker/Kubernetes), including image hardening, pod security policies, and least-privilege configurations
Build and maintain centralized logging, monitoring, and alerting systems (e.g., Datadog) to enable proactive detection of anomalous activity and rapid incident response
Implement and maintain secrets management using tools like AWS Secrets Manager or HashiCorp Vault, eliminating hardcoded credentials across services
Configure and maintain network security controls including WAFs, DDoS protection, TLS certificate management, and network segmentation across environments
Partner with engineering teams to enforce environment parity and prevent configuration drift across development, staging, and production
Coordinate and support penetration testing engagements, remediation tracking, and patch management across servers, containers, and dependencies
Support disaster recovery planning, backup validation, and risk assessment processes aligned with HIPAA contingency plan requirements
Requirements
Bachelor's degree
7+ years of hands-on experience in DevOps, infrastructure engineering, or site reliability engineering, ideally at a growth-stage company
Deep expertise with AWS including: IAM, VPC, ECS or EKS, RDS, S3, CloudWatch, and related HIPAA-eligible services
Strong infrastructure-as-code experience with Terraform or CloudFormation, including security auditing of templates and managing state across environments
Proven track record implementing security controls in CI/CD pipelines (code scanning, secret detection, SAST/DAST tooling)
Hands-on experience with container security: Docker and Kubernetes hardening, image scanning, and runtime policy enforcement
Working knowledge of HIPAA technical safeguards, including PHI encryption at rest and in transit, audit log requirements, and Business Associate Agreements
Strong operational instincts: you write runbooks, you care about on-call hygiene, and you close the loop on incidents with structured postmortems
Nice to Haves
Experience at a healthcare technology company or in another compliance-heavy industry (SOC 2, FedRAMP, PCI DSS)
Familiarity with Datadog or similar observability platforms for log management, APM, and alerting
Exposure to penetration testing coordination or red team/blue team exercises
Experience building or maintaining secrets management systems using HashiCorp Vault or AWS Secrets Manager at scale
Contributions to security culture beyond your immediate role such as documentation, internal security training, or championing secure-by-default engineering practices across the team
Tools You Will Use
AWS
Terraform
Django + Python 3
Node + Typescript
GraphQL
PostgresSQL
Datadog for monitoring and observability
Git / Github / Graphite
Claude Code and Cursor
What We Offer
In addition to offering a competitive salary and equity, we want to ensure every team member has the tools they need to work to the best of their ability. To that end…
We are committed to your Ownership:
We cultivate an environment where team members feel ownership over the work they do. Everyone in an organization has big ideas and we want to hear them and implement them.
All of our employees have equity compensation. We want you to benefit from all the hard work you do in helping patients and catalyzing this shift in healthcare.
We are committed to your Wellness:
Medical, Dental, Vision
401k plan
Flexible PTO and sick days
Commuter benefits
Santa Monica HQ with 180 degree beach views and daily catered lunches
We are committed to your Growth:
Fast paced work environment geared towards professional growth
Get the chance to move roles within the organization to learn new skills and continue to make an impact
We are committed to building Community:
Monthly team events, dinners, & happy hours
Special team outings - some past events have included: yacht cruises, visits to Universal Studios, Magic Castle, and Vegas