Founding AI Engineer (Healthcare)

Clara is building the first AI-first medical practice from the ground up. We're reimagining primary care and providing patients with deep insights and immediate diagnosis and treatment in ways not previously possible. Clara's founders have built and scaled a previous telemedicine company to over $100m in revenue and we're funded by top investors. This is a mission-driven, high-performance team at the forefront of healthcare and AI, working in person in San Francisco 5 days per week. We will assist with relocation and work visas for the right candidate. What you'll build You'll own Clara's AI brain - the LLM-powered system that enables immediate diagnosis and treatment. This isn't chatbot work; it's medical AI that needs to be accurate, safe, and cost-effective at scale. Your responsibilities LLM integration & optimization (50%): Build and optimize LLM integration for medical insights, diagnosis and treatment Implement streaming chat responses with proper error handling Manage context windows for complex medical conversations Optimize prompt engineering for clinical accuracy and safety Control LLM costs through model selection, caching, and prompt efficiency AI infrastructure (30%): Build semantic search and RAG systems Implement vector similarity search for medical record retrieval Design memory systems for patient conversation context Build evaluation framework for groundedness, safety, and correctness Medical AI safety (20%): Ensure AI responses are medically grounded (no hallucinations) Implement guardrails for high-risk medical scenarios Monitor and improve AI quality metrics Token management and cost monitoring What we're looking for Required: 3+ years software engineering, including 12+ months shipping LLM applications to production Strong prompt engineering skills with measurable results Experience with RAG systems and semantic search Python for AI/ML workflows Understanding of token economics and cost optimization Care about AI safety in high-stakes domains Ideal: Medical domain knowledge or healthcare AI experience Experience with embedding models Built evaluation frameworks for LLM quality Vector databases and semantic search systems Memory systems for multi-turn conversations What Clara offers founding engineers Impact: Ship code that affects real patient health outcomes Make architectural decisions for an AI-first medical practice Work directly with CTO on technical strategy Team & culture: High-performance founding team at the forefront of healthcare AI In-person collaboration in San Francisco (5 days/week) Talk to real patients and providers regularly No bureaucracy, ship fast Compensation: Competitive SF salary ranges Meaningful founding team equity Health insurance and standard benefits Growth: First engineering hires → opportunity to become engineering managers as team scales Ownership of entire domains (data, AI, product, platform) Work with cutting-edge AI and healthcare technology