Software Engineer, Agent

About the role

Sierra is building an AI platform to enhance customer interactions for businesses. This role focuses on the Healthcare team, which uses AI agents to manage sensitive conversations for over half of US families. You will contribute to technology that improves patient experiences, making healthcare more accessible and affordable.

Key facts

What you'll do

• Design and implement core healthcare integration tools that allow Sierra agents to securely connect with Electronic Health Records (EHRs) and other healthcare systems.
• Manage production integrations with major platforms like Epic, athenahealth, and Oracle Health, using standards such as FHIR, HL7, APIs, and custom patterns.
• Create reusable platform features for healthcare data access, write-back processes, authentication, authorization, auditing, monitoring, testing, and deployment.
• Collaborate with Agent Engineers to develop and deploy healthcare workflows, including appointment scheduling, patient intake, and CRM updates.
• Act as a technical expert for customer EHR, IT, security, and operations teams, translating requirements into platform capabilities.
• Help establish Sierra's guidelines for safe healthcare agent actions, covering validation, permissions, human review, and data privacy.

Requirements

• 8+ years of hands-on software engineering experience, at a Senior Software Engineer level or higher.
• Significant experience deploying production healthcare integrations while adhering to HIPAA, security, and compliance rules.
• Strong understanding of healthcare interoperability standards like FHIR, HL7, OAuth/SMART authorization, patient identity, data mapping, and EHR APIs.
• Experience building integrations with at least one major EHR or healthcare platform, such as Epic, athenahealth, or MEDITECH.
• Excellent judgment in product and platform design, knowing when to create reusable components versus customer-specific solutions.
• Comfortable engaging directly with customers, including technical executives and security teams, while remaining deeply involved in coding.
• A degree in Computer Science or a related field, or equivalent professional experience.

Nice to have

• Experience building and scaling complete production systems.
• Experience developing or deploying AI/LLM systems in a production environment.
• Prior experience as a founder or founding engineer, balancing craftsmanship, ownership, and speed.
• Familiarity with tools used in AI agents, such as evaluation frameworks, agent tooling, RAG pipelines, and prompt engineering.
• Previous experience with React, TypeScript, or Go.
• Past roles involving customer interaction or leading technical projects with external parties.

Skills & tools

• FHIR
• HL7
• OAuth/SMART
• Epic
• athenahealth
• Oracle Health
• eClinicalWorks
• MEDITECH
• React (nice to have)
• TypeScript (nice to have)
• Go (nice to have)

Practical notes

• Benefits include flexible paid time off, comprehensive medical, dental, and vision coverage, life insurance, disability benefits, a retirement plan, parental leave, fertility benefits, daily lunch, snacks, coffee, and a discretionary benefit stipend.
• Equity participation is available to eligible full-time employees.
• Sierra is an in-person company based in San Francisco, with growing offices in other global cities.