Founding Full-Stack Engineer

Why this role exists

We're building a revenue cycle orchestrator on top of Attune's Agentic Voice platform: claims files come in, get enriched through RAG and EHR/payor integrations, and turn into supervised actions—payor calls, member outreach, appeal packets. This role owns the backbone that ties it together: the workflow engine that sequences those actions and the state that drives the human-in-the-loop portal.

You'll be one of three founding engineers. Expect to make foundational architecture decisions, write production code across the stack, and shape how the whole product hangs together.

What you'll do

• Design and build the workflow orchestration layer: how a claim moves through states, when actions fire, how human approvals gate progress, and how it all stays auditable.
• Build the services behind the approve / deny / kick-off experience—the queues, the state machine, and the APIs the portal runs on.
• Integrate with Attune's voice and agentic APIs to launch and track payor and member calls as first-class workflow actions.
• Make reliability and observability a feature, not an afterthought—retries, idempotency, and clear audit trails in a domain where correctness is money.
• Partner closely with the product lead and the other founding engineers; move fast without leaving a mess.

What we're looking for

• 6+ years building production full-stack software; comfortable owning a service end to end from schema to UI-facing API.
• Strong backend fundamentals: workflow/state-machine design, event-driven systems, queues, and data modeling for complex domains.
• Experience with long-running, multi-step processes and human-in-the-loop or approval workflows.
• Pragmatic full-stack range: primarily backend, but able to build and reason about the front end the portal needs.
• Track record in an early-stage or founding-engineer setting: high autonomy, ambiguous specs, shipping under real constraints.

Nice to have

• Exposure to LangGraph, deterministic orchestration, or agentic/multi-step LLM workflows.
• Healthcare or other regulated, high-reliability domains (HIPAA/PHI, audit requirements).
• Familiarity with claims, RCM, or other document-and-approval-heavy back-office workflows.

How we work

• Small, cross-functional founding pod with a tech lead and a product lead—little overhead, high ownership.
• Bias to prototype → validate → build; instrument everything; learn fast.
• Self-hosted PHI architecture, LangGraph orchestration, and a strong bar for reliability in a regulated domain.
• High autonomy, high bar, candid feedback, low politics.
• Hybrid: 3 days/week in our West Loop office; occasional travel for customer meetings and team onsites.

Compensation & benefits

Competitive base + meaningful founding-team equity; comprehensive health benefits; flexible PTO.

Equal Opportunity

Attune is an equal opportunity employer. We celebrate diversity and are committed to an inclusive environment for all employees.