What are the responsibilities and job description for the Head of Engineering position at Rovi Health (YC F25)?
About Rovi Health
Rovi is an AI-powered care concierge and virtual clinic for employer health plans. We monitor clinical data in real time, catch expensive care before it gets scheduled, and redirect members to higher-quality, lower-cost options. When someone has a condition we can treat directly, we do that through our own virtual clinic.
The problem we’re solving: in-network prices for the same procedure vary up to 10x within a single zip code. A hospital MRI costs $3,000. The independent imaging center ten minutes away charges $500. Same scan, same quality. But nobody tells the patient, the doctor doesn’t know the price, and the employer won’t see the claim for months. So the expensive option wins by default, every time.
Rovi changes that. We deliver high-quality care to member before they choose the expensive or low-quality default. Our AI-native clinic allows us to treat and navigate care, meaning we can reduce outpatient spend by over 30% while improving health outcomes.
We’re live with 30,000 patients today and adding thousands more each month. We’re backed by Y Combinator, Lightspeed, Gradient (Google’s AI fund), Liquid 2 (Joe Montana), and others.
The Role
We have a product in market, real revenue, and an architecture built around autonomous AI agents that make clinical decisions, real-time data pipelines that catch waste before it happens, and a virtual clinic that treats patients directly. We’re at the inflection point where the product works and the demand is accelerating. What we need is the person who turns this into an organization that can operate at 100x the current scale without losing the speed that got us here.
You’ll be in the code and in the customer calls. You’ll review PRs and run architecture discussions. You’ll also hire the first ten engineers, set the bar for what good looks like at Rovi, and build a culture where five people consistently outship teams of fifty.
What You’ll Do
Own the technical platform
At the core of Rovi is an autonomous agent system. Each patient gets their own agent with persistent memory, access to clinical tools, and the ability to make care decisions. These agents operate on real medical data in real time. You’ll own the direction of this platform. When to push capability vs. reliability. How we evaluate clinical AI decisions. Where we’re on the frontier and where we’re behind it.
Build the virtual clinic
We’re not just sending people to better providers. We’re delivering care ourselves. AI handles intake and triage. Clinicians focus on diagnosis and treatment. You’ll architect how these pieces fit together at scale: the intake flows, the async treatment workflows, patient monitoring, and the handoff between AI and human. This is one of the hardest design problems in healthcare right now, and it’s yours.
Scale the clinical data infrastructure
We pull data from health information exchanges, EHR systems, pharmacy feeds, and claims processors. All of it real-time. That infrastructure needs to go from serving thousands of members to hundreds of thousands while staying fast enough that we can intervene before an expensive claim gets locked in. HIPAA compliance across all of it.
Build the team
This is the part that compounds the most. You’ll hire the engineers who set Rovi’s technical culture for the next decade. We’re not trying to build a big team. We want a small group of people who are exceptionally good, who have real autonomy, and who want to stay. The hiring bar you set and the environment you create will matter more than almost anything else you do here.
Shape The Company Alongside The Founders
You’ll be in the room for the hard calls: what do we build next, which market segment do we go after, what are our technical capabilities actually worth as a business. You’ll shape the roadmap, make build-vs-buy calls, and have real influence on company direction.
Who We’re Looking For
Rovi is an AI-powered care concierge and virtual clinic for employer health plans. We monitor clinical data in real time, catch expensive care before it gets scheduled, and redirect members to higher-quality, lower-cost options. When someone has a condition we can treat directly, we do that through our own virtual clinic.
The problem we’re solving: in-network prices for the same procedure vary up to 10x within a single zip code. A hospital MRI costs $3,000. The independent imaging center ten minutes away charges $500. Same scan, same quality. But nobody tells the patient, the doctor doesn’t know the price, and the employer won’t see the claim for months. So the expensive option wins by default, every time.
Rovi changes that. We deliver high-quality care to member before they choose the expensive or low-quality default. Our AI-native clinic allows us to treat and navigate care, meaning we can reduce outpatient spend by over 30% while improving health outcomes.
We’re live with 30,000 patients today and adding thousands more each month. We’re backed by Y Combinator, Lightspeed, Gradient (Google’s AI fund), Liquid 2 (Joe Montana), and others.
The Role
We have a product in market, real revenue, and an architecture built around autonomous AI agents that make clinical decisions, real-time data pipelines that catch waste before it happens, and a virtual clinic that treats patients directly. We’re at the inflection point where the product works and the demand is accelerating. What we need is the person who turns this into an organization that can operate at 100x the current scale without losing the speed that got us here.
You’ll be in the code and in the customer calls. You’ll review PRs and run architecture discussions. You’ll also hire the first ten engineers, set the bar for what good looks like at Rovi, and build a culture where five people consistently outship teams of fifty.
What You’ll Do
Own the technical platform
At the core of Rovi is an autonomous agent system. Each patient gets their own agent with persistent memory, access to clinical tools, and the ability to make care decisions. These agents operate on real medical data in real time. You’ll own the direction of this platform. When to push capability vs. reliability. How we evaluate clinical AI decisions. Where we’re on the frontier and where we’re behind it.
Build the virtual clinic
We’re not just sending people to better providers. We’re delivering care ourselves. AI handles intake and triage. Clinicians focus on diagnosis and treatment. You’ll architect how these pieces fit together at scale: the intake flows, the async treatment workflows, patient monitoring, and the handoff between AI and human. This is one of the hardest design problems in healthcare right now, and it’s yours.
Scale the clinical data infrastructure
We pull data from health information exchanges, EHR systems, pharmacy feeds, and claims processors. All of it real-time. That infrastructure needs to go from serving thousands of members to hundreds of thousands while staying fast enough that we can intervene before an expensive claim gets locked in. HIPAA compliance across all of it.
Build the team
This is the part that compounds the most. You’ll hire the engineers who set Rovi’s technical culture for the next decade. We’re not trying to build a big team. We want a small group of people who are exceptionally good, who have real autonomy, and who want to stay. The hiring bar you set and the environment you create will matter more than almost anything else you do here.
Shape The Company Alongside The Founders
You’ll be in the room for the hard calls: what do we build next, which market segment do we go after, what are our technical capabilities actually worth as a business. You’ll shape the roadmap, make build-vs-buy calls, and have real influence on company direction.
Who We’re Looking For
- 8–12 years in engineering. At least 3 of those leading a team (VP Eng, CTO, Head of Eng) at a startup that was actually growing.
- You’ve built products in regulated, high-stakes environments. Healthcare or fintech, ideally.
- You’ve grown an eng team from a handful of people and kept the quality high the whole way. You know how teams break and how to keep that from happening.
- You still go deep. You have real opinions about system design, you review code, you know when the architecture is drifting.
- You think a small team with high trust and high standards will beat a big team with process every time. You’ve seen it happen.
- $250K–$320K base 1%–2% equity
- Unlimited PTO
- Daily meals in the office
- Wellness stipend
Salary : $250,000 - $320,000