### **Overview:**
We are on a mission to eliminate doctor burnout.
To achieve our mission, Elaborate encodes clinician preferences and guardrails
into a Clinical Context Layer that unlocks AI and automation in enterprise
healthcare.
Healthcare AI has a last-mile problem. Health AI tools are powerful, but
enterprise clinicians need outputs that are safe, clinically precise, and
customized to how they actually practice. The CCL is the infrastructure that
makes that possible: turning raw inference into clinical-grade output across
lab results, pathology, clinical documents, and prescription refills.
Built over 5+ years across 15+ enterprise deployments:
* 2,400+ daily active clinicians
* 12M+ annual clinical interactions
* 97% full clinician agreement
Trusted by market leading health systems and academic medical centers such as
Cedars-Sinai, Community Health Network, and Millennium Physician Group.
Integrated natively with Epic and Athena. Backed by Tusk Ventures, Founder
Collective, Bling Capital, and Arkitekt Ventures.
### **What you 'll own:**
**The architecture of our clinical context layer:** Partner with the clinical
programming team to own the technical architecture of our clinical context
layer - the full system of rules, guardrails, preferences, and configurations
that comprise our clinical logic. That means adding new factors and data
points into the reasoning layer, retiring logic that no longer scales,
refining how configurations interact with one another, and managing client-
and cohort-level customizations so the system stays coherent as it grows. You
are the technical owner of the rule system; the clinical team is the expert
authoring inside it.
**The infrastructure powering clinical operations:** Today, much of our
clinical QA, onboarding, and ongoing data curation relies on expert judgment
and manual review. Your job is to build & own the systems that change that.
Examples include automated marker mappings, automated alerting, safety rails
to prevent a well-meaning global configuration change from breaking a client
customization, tooling that surfaces gaps in the engine, and refining the
logic behind our feedback loops. The goal is to build the system that lets the
clinical programming team own and evolve the logic directly with minimal
manual & rote processes.
**Healthcare data integrations:** Own client integrations end-to-end, from
standing up HL7, FHIR, or API connections, to representing Elaborate on
technical implementation calls, to customizing the configuration logic that
embeds our system into the EMR (print groups, TAOs, and the client-specific
quirks that never appear in the spec). Your ownership extends beyond initial
implementation to building and scaling our AWS infrastructure and shipping
alerting and logging that catches the integration the moment it breaks.
Compliance, performance, and observability are part of your expected scope of
work.
### **Who you are:**
**You 've built technical systems with non-technical domain experts:** This is
the filter we care about most. You've worked closely with someone who holds
the "rules" (e.g. a doctor, nurse, lawyer, accountant, compliance officer,
scientist, policy expert) and your job was to pair their knowledge with
infrastructure that made it work at scale. You know what it feels like to sit
with a domain expert for an hour and come away with a different mental model
than you started with. You know how to ask the question that surfaces the edge
case. You know that "what did you actually mean by that" is the most important
sentence in the room. This is not "I went to meetings with stakeholders." You
translated expert judgment into a system that ran without them.
**You have expertise in building systems vs. patches:** You're infrastructure-
minded. Faced with a messy, evolving problem, you reach for the durable
system, even when you have to put a bridge in place to get through today. You
know the difference between "FHIR is set up" and "FHIR is set up, the data
elements are landing correctly, and everything maps to our system the way we
expected." We don't need a devops engineer. We need someone who, when they see
a process that doesn't scale, raises their hand with a concrete idea for the
system that would replace it. You're comfortable with distributed systems,
queues, workers, data pipelines, and the class of problems that emerge when
data and correctness both matter at the same time.
**You’ve been a large part of a small team:** You’ve worked at a startup
before, and you’ve had significant ownership over a product. You are capable
of directing the majority of your time and energy. You’re excited that there
are not multiple layers of management above you, and you’re down to step up as
needed. You have 0 ego - there is no work that is “below you”, and you’re
excited to do what’s right to push the business in the right direction.
### **Most likely, you have:**
* 4-6+ years backend experience
* Deep understanding of full-stack architecture
* Direct healthcare experience (e.g. Epic, Athena, HL7, FHIR, clinical data)
* Experience building internal tools that replaced human judgment with system judgment
* Experience playing around with incorporating LLM-in-production, even if just for fun on the weekend
* Small-company fluency. You've operated without scaffolding before
* Ambitious & self-starter.
**_Note: Please do not apply if you do not live in the US. We are unable to
hire anyone who does not reside in the United States due to our client
contracts._**
### **Our stack:**
* Our application layers are written primarily in Python (+ Django) on the backend and Typescript (+ NextJS) on the frontend (internal tools)
* We store data in Postgres, Redis, and S3.
* We monitor our applications with Datadog and Sentry
* Our infrastructure is built on AWS + Docker and Terraform, managing CI/CD through Github Actions