Head of Engineering [NYC or SF]

ABOUT AMIGO At Amigo, we're building the clinical AI infrastructure that health systems, life sciences companies, payors, and government agencies run their patient-facing care on. Our agents work across the whole patient journey: pre-visit intake, care navigation, post-visit care plans, and ongoing monitoring. Our mission is to make excellent care accessible to every patient, not rationed by the limits of clinician time. This hasn’t been solved because the underlying record was never built for it. EHRs were designed for billing, not for systems that learn. So instead of layering another point solution on top, we’re rebuilding the medical record as a timeline of clinical events and running agents on top of it that improve with every patient interaction. Unlike single-purpose chatbots or scribes, Amigo is the platform our customers use to build their own agents. That means our work has to hold up across specialties, workflows, and regulatory environments and not just one narrow use case. Our agents have supported more than 4 million patient encounters and are on track to grow tenfold this year. Our work is validated through partnerships with leading academic medical institutions. We’re fresh off our Series A, backed by Tier 1 VCs such as Madrona, General Catalyst, and Optum Ventures. We’re a small team of around 35 people, working in person in New York City and San Francisco. We care deeply about craft, clinical rigor, and the speed at which good ideas reach patients. If you want your work to be measured in outcomes rather than releases, we’d like to hear from you. ABOUT THIS ROLE Before Amigo can deliver agents that clinicians trust, our engineers need a platform they can move quickly and safely on. That means an application layer that ships fast, backend and infrastructure that hold up under clinical load, and a data platform where a patient’s timeline is correct and current. As Head of Engineering, you’ll own all three and the standards they’re held to. You’ll lead a team of established engineers and the ones you hire across application, backend and infrastructure, and data. Engineering here is still taking shape, which means influence over how the organization is structured, how we hire, what we build ourselves, and what we adopt. You’ll set technical direction and the quality bar, and you’ll grow the engineers and future leaders on the team. This role blends technical leadership with product judgment. You’ll work closely with our CTO on technical strategy and partner with the Applied AI and Forward Deployed teams whose deployments depend on the platform, translating what customers actually need into systems that hold up. The ideal candidate brings a strong engineering background, a deep sense of ownership, and the ability to build an organization rather than simply run one. WHAT YOU'LL DO - Lead and grow engineering across application, backend and infrastructure, and data, supporting engineers with mentorship, direct feedback, and clear technical guidance - Hire engineers and develop leaders, building a team that continuously raises its own bar - Drive execution from problem definition through deployment, balancing speed with the reliability a clinical setting demands - Engage deeply in technical discussions, guiding system design and helping the team navigate architectural tradeoffs - Set the engineering culture: how we review code, how we ship, what we consider done, and how we respond when production issues arise - Break large platform problems into increments that deliver value early while still supporting the platform’s long-term direction - Partner with the Applied AI, Forward Deployed, and product teams to align priorities and decide what the platform should absorb versus what remains bespoke per customer - Keep the team fluent in the reliability, security, and privacy implications of what they build in an environment involving patient data WHAT WE'RE LOOKING FOR - A track record of engineering leadership in organizations with a strong engineering culture. - Breadth across more than one of application, backend and infrastructure, and data platform. This role spans all three, so we're looking for a generalist leader rather than a specialist in one area - Experience managing and developing engineers, including hiring, mentorship, and performance conversations, with examples of people who grew under you - A strong technical background, and enough current depth to engage credibly in system design, architecture, and tradeoff decisions - The ability to translate customer needs and engineering goals into a roadmap and then into shipped systems - Excellent communication across engineering, product, and the customer-facing teams, including the judgment to know when to escalate and when to absorb - A deep sense of ownership for both team outcomes and long-term system health - Comfort with ambiguity. Priorities move as deployments teach us what customers actually need - Healthcare experience is not required. Strong engineering leadership transfers, and the clinical context is learnable NICE TO HAVE - Experience leading engineering inside a data-heavy company, or owning a data platform alongside application and backend teams - Background in highly scalable distributed systems or infrastructure platforms - Experience building platforms or products consumed directly by other engineers - Familiarity with regulated environments, whether healthcare, financial services, or the public sector BENEFITS (AVAILABLE TO FULL-TIME EMPLOYEES) HEALTH & WELLNESS - Comprehensive health, dental, and vision insurance - Daily catered lunch and dinner - Mental health support and wellness coaching - Flexible wellness stipend for fitness, therapy, or personal growth GROWTH & DEVELOPMENT - Annual learning budget for courses, books, or conferences - Conference attendance budget for professional development - Annual team offsite - Academic collaboration opportunities - Unlimited PTO OUR CORE VALUES 1. Patients Win, We Win If patients aren't getting better care, we haven't earned the right to scale. Every internal decision gets pressure-tested: does this make patients' lives better? If we can't draw the line, we question why we're doing it. 2. High Standards, High Care We hold a high bar for the team because patients are counting on us to get this right. But high standards only work with genuine investment in each other. You can take risks, admit mistakes, and challenge ideas—not despite our standards, but because of them. 3. Thoughtful Urgency We move fast by default, but speed without judgment is recklessness. The discipline is knowing which decisions are reversible vs. not. In healthcare AI, the companies that win will be fast everywhere they can be and careful everywhere they must be. We build the muscle to do both. 4. Intensely Measured We instrument patient outcomes, provider ROI, system performance, and clinical accuracy. But data without action is surveillance. Every metric should have an owner, a threshold, and a response plan. If we're measuring something but never acting on it, we stop measuring it. WHO BUILDS WITH US - Low ego: Politics and territory don't interest you. The best ideas win, regardless of who has them. - Direct: You say the hard thing, challenge ideas openly, and commit fully once decided. - High agency: You thrive on trust rather than instruction. When you see something is broken, you fix it. You don’t file tickets and wait for someone else. - Bar of excellence: You hold yourself to a bar most people wouldn't, and you want teammates who do the same. - Skeptical: You push back on rules that don’t make sense and question assumptions that haven’t earned their place.