Staff Software Engineer (US)

You've probably been to a therapist, or know someone who has. You also probably know that paying for one is broken in ways most things in 2026 aren't. They "think" they take your insurance. The benefits summary you call to verify turns out to be wrong. Six weeks later, a bill arrives for an amount nobody warned you about.

Behind every one of those moments is a clinic doing the work by hand. Armies of people make eligibility calls, fax prior auths, type claims into payer portals one at a time, and chase denials months after the visit. Good clinicians leave the field over it.

Supa Health is building the agentic operating system that makes this work disappear — an AI scribe, an AI receptionist, and an agentic back office that handles benefits verification, prior auth, intake, and claims. Every call its agents make, every denial they work, every payer quirk they encounter feeds back into a system that gets sharper the next time. We're building software that compounds.

We're not selling dashboards. We're replacing the work itself.

Small team, $5M from Peak XV (formerly Sequoia India), shipping fast. Looking for our founding product engineer.

The Staff engineer at Supa Health is the technical center of gravity for the team. You'll partner directly with the CTO and product to shape where we go and how we get there, and you'll be the person who makes sure the work actually gets there.

That means:

• Architecture and direction. You own the hard architectural calls — how the agent platform evolves, how data flows across surfaces, how we keep multi-tenancy and HIPAA-grade segregation honest as the system grows. You phase the work in a way that lets us ship every week, not every quarter.

• The quality bar. You set what "good" looks like here. Code reviews, conventions, testing, observability, the standards we hold each other to. Not by writing a 40-page wiki nobody reads, but by example — and by being the person whose review the team most wants to get.

• Project execution. You break large pieces of work into milestones, drive them to completion, and unblock the people working on them. You know when to cut scope, when to spend the extra week getting it right, and when to throw the prototype away.

• Technical communication. You're the translation layer between engineering and the rest of the company. Product knows what's possible because you told them. The CTO trusts your read on technical risk. Customers get the right answer because you helped shape it.

• Building, still. This is not a hands-off role. You write code, you ship, you stay close enough to the system that your judgment is grounded in what's actually there.

You'll talk to operators. You'll talk to clinic owners. You'll watch someone do their job for two hours and then go automate the painful parts of it. You'll ship something on Tuesday and see it running in production on Wednesday.

• Craft as a discipline. You take pride in the details — naming, structure, the difference between code that works and code that lasts. You advocate for high-quality engineering not as a luxury but as the thing that lets us move fast for years instead of months. You can articulate why a design is better, not just that it is.

• Architectural judgment. You can hold the whole system in your head and make calls about where complexity should live. You know when to invest in abstraction and when to cut a straight line through. You phase migrations and rewrites so the team keeps shipping the entire time.

• Code review as leverage. You review code that makes the people around you better — specific, kind, and consistently raising the bar. You see review as one of the highest-leverage things a Staff engineer does, not as a chore between meetings.

• Project ownership. You take a piece of work from "we should probably do this" through milestones, scope cuts, and the unglamorous middle, all the way to shipped. You communicate status without being asked. You name risks early.

• Direction. You work with users, product, and the CTO to figure out what to build and how to build it. You sit with operators, watch where they get stuck, and come back with a sharper definition of the problem than we started with. You're a thought partner — not someone waiting for a spec, and not someone going off in a vacuum.

• Speed. Not crashed-out hustle-culture speed. The kind that comes from deleting unnecessary work, making decisions quickly, and not being precious about being wrong.

• Range. You don't need to be a 10/10 at frontend, backend, infra, AI, and product. You do need to be the person on the team who can dive into whichever of those is on fire this week.

10+ years building production software, with meaningful time at the senior or staff level. We care about the slope as much as the years — what you've shipped, what you learned the hard way, and what you'd do differently now. You've lived in TypeScript and Postgres long enough to have real opinions about both, and you've designed systems that other engineers had to live with for years.

Bonus, not required:

• Agentic AI / LLM systems. You've built something with agents, tools, evals, and the unglamorous plumbing around them. You know when an LLM is the right answer and when it's a fancy way to make a slow, wrong API call.

• Early-stage startup experience. You know what it feels like to have no design system, no playbook, no PM, and a customer call in 90 minutes.

• Healthcare / RCM background. You know what a 271 is. You've fought with a clearinghouse. You have feelings about Availity. This is rare and we'd love to find it, but we'll happily teach the right person.

This role is IC. We expect the Staff engineer to lead technically — through architecture, code review, and the standards they set — not through a reporting line.

If you eventually want to grow into people management, there will be paths to that as the team scales. If you want to stay an IC for the rest of your career, that's also a complete answer here, and the work doesn't get smaller.

• Compensation. Salary in the 200K-240K range plus meaningful founding-team equity, both calibrated to seniority and scope. We'll be specific in the first conversation.

• Health, dental, vision. Fully covered.

• 401(K) with match.

• In-person in the San Francisco is the default — small teams move faster in a room together. We'll consider remote or hybrid setups for exceptional candidates.

• Meals. Lunch, dinner, and snacks on the company.

We borrowed our process from Linear because we think they got it right.

1. Intro call with the CTO. ~30 minutes. We talk about you, the company, and whether the role fits. We'll discuss comp on this call.

2. Technical conversation. ~60 minutes. We work through a real problem together. No leetcode.

3. Architecture conversation. ~60 minutes. We walk through a system you've designed and built, and we look at one of ours.

4. Paid work trial. 2–5 days, paid at our standard daily rate. You work on something real. You meet the team. You leave with a much clearer picture of whether Supa Health is the right place for you, and we leave with a much clearer picture of whether you're the right person for Supa Health.

5. Decision. Independent feedback from the trial team, then a debrief, then an offer (or honest feedback if not).

We aim to go from intro call to offer in 1–2 weeks.

We'd rather be honest now than waste your time later.

• If you've moved away from writing code, this isn't it. Staff here means staff-level IC work, not architecture astronaut.

• If you set direction by writing documents and waiting for buy-in, you'll be frustrated. Direction here is set by talking to the team, sketching, prototyping, and arguing the right calls into existence.

• If you want a 9-to-5, that's a legitimate choice, and it isn't this job. We don't expect crunch, but we expect early-team intensity.

• If you're allergic to talking to users, this won't work. Operators and clinic owners are part of your job, not someone else's.

• If you want a corner of the system to be solely yours, the Staff role spans surfaces by design. You'll have a point of view on all of it.

If you read all of that and you're more interested than when you started, we want to talk..