Founding Full Stack Engineer

About Solum Health

Solum automates the insurance work behind outpatient care: verifying benefits, getting prior authorizations approved, and finding coverage patients didn't know they had.

For an outpatient provider group, every new patient sets off the same chain of admin work. Someone checks the patient's coverage on an insurer's website, works out what's actually covered, calls the insurer when the website doesn't answer the question, pulls clinical documents together for an authorization, faxes it, and follows up for days. When any step is late or wrong, the patient's start date slips or the claim gets denied.

We replace that chain with software. Our customers include some of the largest PE-backed and outpatient provider groups in the U.S. We're backed by Y Combinator, Liquid 2 Ventures, FundersClub, and Wisdom Ventures, along with founders and operators including Immad Akhund (Mercury), Sebastian Mejia (Rappi), and Bradley Horowitz (former VP Product, Google).

What you'll automate

You'll build the automations that handle insurance work for our customers, starting with outpatient facilities:

• Insurance verification. Confirm what a patient's plan covers and what they'll owe, quickly and accurately, without anyone waiting on hold.
• Prior authorization. Gather the right documents, send the request to the insurer, and follow it until there's an answer.
• Coverage detection. Find insurance a patient has but didn't mention, before the bill goes out.

That means AI agents that read documents, work through insurer websites, connect to the systems our customers already use, and know when to hand a case to a person. You'll write and improve the prompts behind those agents, test them on real cases, and measure how accurate they are on live work. You'll ship features across a Next.js frontend and a FastAPI backend, and use workflow tools like n8n where they're the right fit. You'll also work directly with customer teams to deploy these automations inside their organizations.

How we build

At least 90% of the code we ship is written with Claude Code and Codex. Engineers here spend their time directing agents, reviewing every change carefully, writing tests, and owning what goes to production. We expect you to already work this way, and we'll ask you to show us how.

What we're looking for

Required

• 3+ years in AI/ML or full-stack engineering, with production systems you owned from first version to live use.
• You already write most of your code with Claude Code, Codex, or similar coding agents, and you have a reliable way of reviewing and testing what they produce.
• Production LLM experience: prompt design and versioning, evals, and A/B testing on real traffic.
• Integration work with messy external systems: third-party APIs, webhooks, browser automation, and document or file processing.
• Comfort working across frontend, backend, and AI systems.

Ideally

• Startup experience, especially at an early stage company where you shipped every week and owned outcomes, not tickets.
• Experience in healthcare, health insurance, medical billing, or a related industry.

Why this role

• You'll be one of our first engineers, and you'll own the automations that our product is built on.
• What you ship is used by large provider groups within days, and you'll see its effect in their patient and claims workflows.
• You'll work directly with the founders and with customers, and you'll help decide how the team and the company grow.

How we work

We're a small team taking on a big problem, and the pace reflects that. Most of us work more than 12 hours a day, and weekend work is common. We're telling you up front so you can decide whether this is the right time in your career for it. If it is, we'd like to talk.