Founding Engineer
Job description
Founding Engineer at Leland Care
Leland Care exists to solve a critical problem in senior healthcare. Across the United States, the typical older adult sees seven different physicians across four distinct medical practices. These patients also interact with insurers, pharmacies, family members, and facility staff. The result is a chaotic picture where no single individual ever sees the complete story. Health data is fragmented across incompatible digital systems. Families and seniors are forced to manage this disorganization instead of focusing on living well. The consequence is missed information and lost opportunities for better care.
Leland Care is building the first unified system of record for aging. The mission is to help seniors live longer, healthier, and happier lives. The company creates one complete record that combines a senior's health status with the context of their life. With this comprehensive view, artificial intelligence can intelligently analyze the entire picture. It surfaces risks, identifies gaps, and highlights opportunities. Human navigators, who are the senior's trusted guides, then take this intelligence and direct the next best actions. They remove the friction that often prevents families from following through. This transforms scattered information into proactive, coordinated support that extends healthy, independent years. The company already has a multi-year funding runway. Leland Care is launching pilots in 2026 with healthcare providers and is engaged in active conversations with major US health systems. The company is led by a Stanford Graduate School of Business founder with a track record of scaling new businesses at Sword Health and Homebase.
About the Role
The Founding Engineer is the first technical hire and the technical leader of the platform. This is a 0-1 role with the responsibility to build the core foundation from the ground up. The engineer will own the entire architecture, the data ingestion pipelines, the storage systems, the intelligence layer, and the initial agentic automation. The goal is to turn a complete record of a senior's health and life into coordinated action. Success requires making high-use technical decisions and shipping functional products quickly. The engineer will work closely with human navigators to ensure technology enables, rather than complicates, care.
Leland Care operates through four distinct layers of technology and workflow.
The Ingest & Store layer focuses on data consolidation. The engineer will build intake pipelines that pull information from across the healthcare system. This includes medical records, insurance details, and medication lists. The role also incorporates real-world context about family, caretakers, daily appointments, and routines. The objective is to construct one clean, reliable record instead of scattered fragments.
The Intelligence layer leverages artificial intelligence. The engineer will establish workflows where models continuously analyze the complete picture of a senior's life. These models detect health risks, care gaps, and potential opportunities. The output prioritizes what truly matters for action.
The Action layer involves building agentic modules. The engineer will create systems that execute real coordination work. This includes scheduling appointments, managing logistics, reconciling information, and handling documentation. Throughout this process, the human navigator remains in the loop with full visibility and control.
The Compliance layer ensures responsibility. Every action taken by the system is properly documented and auditable. This design allows the platform to scale responsibly and meet regulatory standards.
Who We Are Looking For
The ideal candidate is a builder who has created real systems independently. You must take extreme ownership of problems from start to finish, covering design, code, and deployment. You exhibit high agency, moving fast and solving problems without waiting for perfect requirements or ideal conditions. You thrive when there is ambiguity and chaos. You prefer clear goals and maximum freedom over heavy process and hand-holding. You are genuinely excited to work on difficult problems that impact vulnerable people. Fixing broken parts of the healthcare system for those who need it most is meaningful work. You are a first-principles thinker with strong technical judgment. You make pragmatic architecture choices and deliver high-quality work on a fast timeline. You have a low ego but high output. You want the intensity and ownership that exists only at the earliest stage of a company. If you require constant direction, detailed roadmaps, or a narrowly defined role, this position is not the right fit.
Logistics
Location is New York City. The engagement is for full-time work. The compensation package is between $180,000 and $260,000 USD per year.