Principal Engineer, Technical Lead (Healthtech)

W2 only, no C2C, must be authorized to work in the US (both now and in the future).
Principal Engineer, Technical Lead (Healthtech) (Direct Hire) - Remote in Covina, California. Apply now for this opportunity at Carex!
Carex is partnering with a Healthtech partner to hire a Technical Lead / Lead Software Engineer to drive technical strategy, architecture, and hands-on software development for an innovative, early-stage company building AI-powered solutions for healthcare organizations. The platform evaluates patient interactions and clinical documentation against organizational protocols, patient safety standards, and regulatory requirements, supporting care delivered by clinicians, AI agents, and AI scribes.
This is a highly impactful, hands-on technical leadership opportunity for an experienced engineer who thrives in early-stage environments and enjoys balancing strategic decision-making with writing production code. As the senior-most engineer, this individual will report directly to the CEO and lead technical execution across a small, distributed engineering team. The ideal candidate comes from a fast-paced startup environment and brings deep experience building scalable, real-time systems, deploying and evaluating large language model (LLM) applications, and developing secure solutions involving sensitive or regulated data. This role requires strong technical judgment, ownership of engineering outcomes, and the ability to guide a team while remaining actively involved in coding, architecture, and delivery.
What You'll Do

• Own technical architecture and engineering strategy across real-time audio processing, transcription, AI-driven scoring, and integration services.
• Design, develop, and maintain scalable production applications using Python, TypeScript, AWS, and modern AI technologies.
• Serve as the senior technical decision-maker, establishing architectural direction, engineering standards, and long-term platform scalability.
• Evaluate and select AI models, infrastructure solutions, and third-party vendors based on performance, reliability, cost, security, and HIPAA compliance requirements.
• Lead the development, deployment, and evaluation of LLM-powered capabilities, ensuring accuracy, reliability, and measurable performance.
• Drive engineering execution through sprint planning, prioritization, technical scoping, and coordination across a distributed team.
• Remain actively involved in hands-on software development, code reviews, troubleshooting, and complex technical problem-solving.
• Establish and maintain engineering best practices for testing, deployment, monitoring, incident response, and production reliability.
• Lead technical security initiatives, including SOC 2 readiness, compliance processes, and secure handling of protected health information (PHI).
• Serve as the primary technical contact for enterprise healthcare customers, supporting technical discussions, integrations, and solution architecture.
• Provide technical expertise during customer evaluations, investor due diligence, and strategic business discussions.
• Identify opportunities to improve system performance, engineering efficiency, and product capabilities.
• Foster a collaborative engineering culture built on accountability, constructive technical debate, transparency, and continuous improvement.
  

What You'll Bring

• Extensive hands-on software engineering experience, including experience serving as a senior technical leader, lead engineer, or equivalent in an early-stage company or startup environment.
• Experience operating as the senior-most engineer, or in a comparable technical leadership capacity, within an organization of approximately 30 employees or fewer.
• Proven experience designing, building, deploying, and scaling real-time or streaming systems in production environments.
• Strong proficiency in Python and TypeScript, with experience developing cloud-native applications and distributed services.
• Hands-on experience with AWS infrastructure, including deploying, operating, and maintaining reliable production systems.
• Demonstrated experience delivering LLM-powered applications or features, including model selection, evaluation methodologies, performance optimization, and production monitoring.
• Experience working with sensitive or regulated data, with a strong understanding of security, privacy, and compliance requirements; HIPAA and PHI experience strongly preferred.
• Experience providing technical leadership to small, geographically distributed engineering teams while maintaining significant individual coding responsibilities.
• Strong understanding of software architecture, system design, API development, scalability, and integration patterns.
• Experience establishing engineering standards and managing production reliability, incident response, and software release processes.
• Ability to translate business and product requirements into actionable technical plans, sprint objectives, and engineering deliverables.
• Strong communication skills with the ability to explain complex technical concepts to executives, customers, investors, and engineering stakeholders.
• A proactive, ownership-driven mindset with a strong commitment to quality, reliability, and continuous improvement.
• A collaborative approach to technical decision-making, including the ability to challenge assumptions, engage in constructive debate, and align around decisions.
  

Preferred Qualifications:

• Experience developing speech-to-text technologies, audio processing pipelines, or real-time transcription systems.
• Familiarity with telephony platforms, voice AI applications, or streaming audio infrastructure.
• Experience integrating with electronic health record (EHR) systems or other healthcare technology platforms.
• Experience leading or supporting SOC 2 compliance initiatives, security audits, or certification readiness.
• Experience building enterprise-grade AI solutions for healthcare providers, health systems, or health plans.
• Comfort working directly with executive leadership in a fast-moving, resource-conscious startup environment.
  

Carex Consulting Group is an equal opportunity employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, marital status, disability, gender identity or Veteran status.