Senior Software Engineer - AI Systems

Senior Software Engineer (Agentic AI / Healthcare)Location: New York, NY (Manhattan), Hybrid (3 days onsite)Compensation: $150,000–$250,000 base equityContact / Apply: Ryan Johnston - ryan@nxtlevel.io About Our ClientOur client is a venture-backed healthcare technology company based in New York and Toronto, building agentic AI solutions that reimagine how medications are prescribed, verified, and supported across the pharmacy ecosystem. Backed by $4M in funding and trusted by multiple Fortune 50 healthcare organizations, they're scaling quickly and expanding their AI product line.As an early engineering hire, you'll play a meaningful role in shaping architecture, shipping production systems, and balancing speed with quality. The work directly impacts pharmacy workflows and, most importantly, patient outcomes.MissionOur client is building a world where medication delays are impossible. From the moment a prescription is written, the path to therapy start should be clear, fast, and predictable. Their platform connects the fragmented steps that slow medication access, intake, coordination, utilization management, and clinical services, so patients start therapy sooner.The RoleOur client is hiring a Senior Software Engineer to design and build autonomous, agentic systems that run complex, multi-step pharmaceutical workflows end-to-end. This is a backend-leaning role with broad scope: you'll work across orchestration, integrations, reliability/observability, and the practical realities of healthcare systems.This role is ideal for someone who enjoys ambiguous problems, can ship end-to-end, and wants to build real product in a regulated, high-stakes domain.What You'll DoDesign and build autonomous agents that handle multi-step pharmacy workflows end-to-endArchitect communication systems that coordinate across organizational boundaries (providers, payers, pharmacies, vendors)Build orchestration layers for long-running tasks, including graceful failure handling and human-in-the-loop escalationDevelop frameworks enabling agents to interact with external pharmacy systems, databases, and APIsImplement evaluation observability infrastructure to monitor agent behavior in production (quality, drift, failure modes)Integrate with healthcare data standards and legacy pharmacy systemsScale systems for real-time processing across multiple pharmacy networksWhat Our Client Is Looking ForMust-Have Qualifications5 years of software engineering experience with a strong backend focusProficiency in Python or TypeScript and deep backend fundamentals (APIs, data stores, concurrency, distributed systems)Experience with service-oriented architectures and web frameworks (FastAPI, Flask, or equivalent)Strong API design skills (clean, versioned APIs)Familiarity with caching, messaging, and databases (e.g., Redis, Kafka, SQL/NoSQL, vector databases) and how to apply them for performance and reliabilityCloud experience (Azure, AWS, or GCP)Experience building and deploying agentic AI systems, including tool use, planning, memory, and orchestration patternsProven ability to ship ambiguous projects end-to-end with minimal guidance and own outcomesBased in NYC and able to commute to Manhattan 3 days/weekNice-to-HavesExperience integrating with healthcare/pharmacy systems or healthcare data standardsExperience building evaluation harnesses for agent reliability and hallucination mitigationPrior work in regulated environments where correctness and auditability matterCompensation & PerksCompetitive compensation: $150k–$250k base stock optionsFull medical, dental, vision coverageUnlimited PTO 2 weeks company-wide holiday closureComplimentary breakfast daily and weekly team lunches (in-office)Professional development stipendWhy This RoleThis is a rare opportunity to be early, own architecture, and build agentic systems that directly improve medication access—where execution quality matters and the impact is tangible.

Salary : $150,000 - $250,000