About this role
Senior AI Engineer — Voice & Agentic Systems
Full time
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Remote | Boston, MA | Onsite
1 - 10 Years of Experience
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Who is Recruiting from Scratch:
Recruiting from Scratch is a premier talent firm that focuses on placing the best product managers, software, and hardware talent at innovative companies. Our team is 100% remote and we work with teams across the United States to help them hire.
Senior AI Engineer — Voice & Agentic Systems
Location: Remote (US) / Hybrid (Boston or San Francisco) Company Stage of Funding: Seed ($2.5M raised) Office Type: Remote / Onsite Salary: $180,000 – $250,000 + Competitive Equity Visa: H1B transfers / TN only (No new sponsorship)
Company Description
Our client is building personalized AI healthcare infrastructure for Medicare beneficiaries, combining voice AI, reinforcement learning systems, and agentic automation to create a scalable AI nurse concierge.
Their platform automates care coordination workflows across insurance, providers, vendors, and patient support systems—bringing always-on personalized healthcare navigation to millions of patients.
This is an opportunity to join an early-stage, venture-backed healthcare AI company building production-grade voice and agentic systems in one of the most impactful AI application spaces today.
What You Will Do
- Build and deploy production-grade voice AI systems
- Design agentic workflows for healthcare automation
- Build multi-agent orchestration systems
- Develop reinforcement learning feedback loops
- Design evaluation infrastructure for agent performance
- Improve AI quality through reward-driven optimization
- Build real-time STT / TTS pipelines
- Create autonomous care coordination agents
- Design workflow orchestration systems
- Improve production reliability for patient-facing AI systems
- Build data capture pipelines for model improvement
- Work directly with founders on technical roadmap
- Own AI system performance end-to-end
- Design scalable healthcare AI infrastructure
- Ship rapidly in a high-ownership startup environment
- Drive product iteration from real-world usage data
- Lay architectural foundations for scale
- Improve system accuracy using continuous feedback loops
Ideal Candidate Background
- 1–10 years of engineering experience
- Strong backend or full-stack engineering fundamentals
- Strong Python proficiency
- Experience shipping production AI systems
- Strong systems design fundamentals
- Comfort with ambiguity
- High ownership mindset
- Ability to work autonomously
- Strong technical judgment
- Fast learner
- Strong product intuition
- Comfort operating in highly unstructured environments
- Ability to move quickly
- Strong debugging and optimization skills
- Ability to work directly with founders
Strong Signals
- Built production voice AI systems
- Built production agentic systems
- Multi-agent orchestration experience
- RLHF / reward modeling experience
- Built eval-driven LLM systems
- Production reinforcement learning systems
- Real-time STT / TTS pipeline experience
- Healthcare AI experience
- Startup engineering experience
- Former founder / early engineer
- Strong AI infrastructure background
- Top technical education
- Demonstrated exceptional technical achievement
- Experience building feedback-loop systems
- Strong experimentation mindset
- Fast shipping velocity
- High ambiguity tolerance
- Experience with production-scale LLM optimization
Compensation and Benefits
Base salary: $180,000 – $250,000
Competitive equity
Remote-first flexibility
Hybrid option in Boston / SF
Direct founder collaboration
High technical ownership
Meaningful architectural influence
Early-stage upside
Mission-driven healthcare impact
Production-scale AI challenges
Why Join
This is a rare opportunity to build AI systems that directly improve patient outcomes.
You’ll work on production-grade voice and agentic systems that automate complex healthcare coordination workflows, helping scale personalized care for Medicare beneficiaries.
If you want deep ownership over cutting-edge AI infrastructure, real-world impact, and the opportunity to build systems that continuously learn and improve from patient interactions, this role offers exceptional leverage.
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