Senior Founding Engineer, Core Product

Alpaca Health · New York City · Full-time

About Alpaca

Alpaca Health is the operating system for autism care. We make it possible for clinicians to start and run their own practices — handling the operational complexity that usually stops them. Billing, payroll, payouts, intake, clinical workflows, parent communication. We handle it all so they can focus on delivering care.

Nearly 50 clinicians have launched their businesses on Alpaca. Over 200 children receive care through our platform every day. We're at $1.8M ARR, growing 30% month-over-month. Small team, everyone owns real problems end-to-end. No filler roles.

The Role

Alpaca runs a lot of complex operations — payroll, billing, insurance claims, intake, eligibility — and today, too much of it depends on people catching things by hand. The numbers are right, but only because smart people check them every cycle.

Your job is to make that unnecessary. You'll build the automation, tooling, and product workflows that turn manual checklists into durable systems. Monday might be a backend pipeline that validates payroll before anyone looks at it. Wednesday might be a parent-facing UI that shows a family exactly what they'll owe before a surprise bill shows up months later. Friday might be an LLM-powered workflow that cuts hours of clinical documentation down to minutes.

You work across the stack. You lean systems, but you build product when it matters — and at Alpaca, it matters a lot.

You'll be one of the first five engineering hires and report directly to the CTO.

What You'll Own

• Reconciliation and audit tooling. Build the systems that validate payroll, payouts, and billing before any human reviews them. "Is this number right?" becomes a dashboard, not a Slack message to the CTO.
• Workflow automation. Convert manual ops processes — intake, eligibility checks, end-of-period processing — into guardrailed automation that handles the happy path and flags the exceptions.
• Patient responsibility. Build the calculation and disclosure system that gives parents clear, accurate expectations about costs — before they get a surprise bill months later.
• AI-powered workflows. Build LLM-driven features that reduce operational and clinical burden — documentation assistance, intake automation, intelligent routing. Own making these features reliable and safe in a healthcare context.
• End-to-end testing on critical paths. The reconciliation tooling you build is itself a form of continuous testing. Own the confidence that core workflows produce correct results across edge cases.

How You'll Work With the Team

You'll pair closely with our senior billing engineer, who carries deep domain knowledge about payer-specific edge cases, billing rules, and payout conditions. Today he executes that knowledge manually every cycle. Your job is to encode it into automated workflows so he can shift from doing the manual work to owning the correctness of the automated version.

Our platform engineer will be building the foundational domain models and invariants. You build the product and automation layers on top of that foundation — the systems and interfaces that turn platform correctness into operational leverage.

What We're Looking For

• 3+ years of experience in fintech, payments, billing, or a similar domain where money has to be exactly right.
• You're obsessed with correctness and idempotency. You think about what happens when a job runs twice, a webhook fires out of order, or a record updates mid-calculation. You don't hand-wave edge cases.
• You build across the stack. You're comfortable writing a backend reconciliation pipeline and a product interface in the same sprint. You lean systems, but you can build the UI when it matters.
• You build tooling, not just features. You've built reconciliation systems, audit logs, internal dashboards, or workflow engines. You find satisfaction in making manual processes disappear permanently.
• You're comfortable with ambiguity. The business rules you're automating are still being discovered. You can work with incomplete specs, ask XXXX XXXX questions, and ship something that handles edge cases gracefully rather than waiting for a perfect spec that never arrives.
• You ship quickly and iterate. We're a small, fast team. You own your work end-to-end — from understanding the manual process, to building the automation, to proving it's correct.

Nice to Have

• Data engineering experience (pipelines, ETL, data validation)
• Experience with healthcare billing, claims processing, or insurance workflows
• Experience building LLM-powered features in production — prompt engineering, RAG, evaluation, guardrails
• Background building internal tools or ops automation platforms

Why Alpaca

Alpaca's vision is an autonomous clinic — a system that handles the full operational complexity of running an autism care practice so that humans can focus on clinical care and family relationships. Every manual process you automate moves us closer. Every reconciliation check you build reduces the risk that a family gets a wrong bill or a therapist gets paid incorrectly. Every AI workflow you ship gives clinicians hours back.

You'd be joining early enough to shape how the product works, with enough traction that you're not guessing whether anyone wants it. The product is live, the growth is real, and the problems are worth solving.