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Head of Engineering, Platform

Roles & Responsibilities

  • Built and shipped real platform systems: distributed architecture, async pipelines, real-time audio/ML workloads, multi-tenant backend
  • Hands-on coder who still writes code (player-coach) with direct engineering depth
  • Led engineers and delivered impact in small teams, focusing on architectural quality and execution
  • Experience in high-intensity environments (YC-backed/seed-stage/zero-to-one) with speed and sound judgment

Requirements:

  • End-to-end platform engineering: Agentic scribe pipeline, copilot-backend, AI workers, EHR sync, multi-tenant infrastructure, and real-time audio processing
  • Drive-function latency improvements: targeting 50%+ cuts across AI generation workflows (note generation, decision support, real-time agent actions)
  • Observability, alerting, and model-selection systems that provide meaningful signals at scale
  • Continuous quality pipelines: ensure accuracy, completeness, and reliability of every AI output across all orgs and EHR integrations

Job description

About Us
At Sully.ai, We’re Building the Most Impactful Healthcare Company on Earth

We believe that access to a great doctor is a basic human right. Today, that’s not a reality. Delays, misdiagnoses, administrative chaos, and burnout plague the system.

Our Mission
One Human, One Doctor.
We enable our customers to staff 30% of their workforce with AI by creating a shared agent architecture for scale and efficiency. All powered by our own patented, world-class models and deployed in real-world care.


About the Role

Sully automates clinical documentation at the point of care. Real-time ambient listening, structured medical notes, and agentic AI workflows embedded in the EHR. We're live in 270+ clinics, have processed 2M+ real physician-patient encounters, and run on custom medical models that outperform GPT, Claude and Gemini on clinical benchmarks. We're not a wrapper company.

We're hiring a hands on Head of Engineering, Platform to take full ownership of Sully's platform domain: the agentic scribe pipeline, copilot backend, AI workers, EHR integration layer, and the infrastructure that ties them together.
Platform is the engine: Every note generated, every EHR sync, every real-time AI action in a patient visit runs through what you build.
You will be the DRI for platform architecture, reliability, latency, and execution, from design through on-call.

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What You'll Own

End-to-end platform engineering: Agentic scribe pipeline, copilot-backend, AI workers, EHR sync, multi-tenant infrastructure, and real-time audio processing
Drive-function latency improvements: targeting 50%+ cuts across AI generation workflows (note gen, decision support, real-time agent actions)
• Observability, alerting, and model-selection systems that give real signal at scale
Continuous quality pipelines: accuracy, completeness, and reliability of every AI output across all orgs and EHR integrations
Execution cadences: OKRs, standups, backlog ownership in Linear, tight coordination with Scribe, Receptionist, Integrations, and Research
Engineering bar across the stack: architecture decisions, PR reviews, on-call standards, and operational rigor
Platform roadmap translation: from product goals and research breakthroughs to clear technical plans with real timelines

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What We're Looking For

You've built and shipped real platform systems: Distributed architecture, async pipelines, real-time audio/ML workloads, multi-tenant backend. Not just CRUD services. You can go deep on system design and come back with something that actually scales.
You still write code: Player-coach. We evaluate hands-on engineering depth directly.
You've led engineers: made them sharper, not just coordinated their sprints. Small team is fine. Impact is what matters.
You've operated in high-intensity environments: YC-backed, seed-stage, zero-to-one. Speed and judgment over process. You've felt what it means when the platform is down and the whole company is waiting.
Healthcare or high-reliability software experience is a strong signal: You understand what it means to build systems where errors have real consequences.
Ambiguity is your operating system: You convert incomplete direction into clear plans and shipped systems. No hand-holding needed.

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First 90 Days

Take full ownership of the platform domain: establish yourself as the DRI for architecture, reliability, and delivery decisions
Ensure end-to-end observability and alerting for core platform workflows: note generation pipeline, EHR sync, AI worker health, and real-time audio processing
Define key platform metrics: p50/p99 latency, pipeline completion rate, EHR sync reliability (target ≥98%), error rates by service
Identify and ship at least one high-impact improvement: latency reduction, reliability fix, or architecture simplification
Establish execution cadence: OKRs, on-call standards, and quality benchmarks across the platform stack

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Why Sully

Real Product Market Fit: 270+ clinics live, 2M+ encounters processed, physicians choosing it every day in patient visits
Custom medical models: we build our own and they win on clinical benchmarks
The platform challenges are real and immediate: sub-second AI inference, multi-EHR sync, real-time audio pipelines, distributed agentic workflows at scale

You're replacing a genuinely broken workflow (manual documentation = physician burnout), not adding an AI feature
Small team, large surface area, high ownership: If you want to own the platform infrastructure of a company defining how AI works in healthcare, this is it

Why Join Sully.ai?
🔥 Revolutionizing the antiquated $800B+ Healthcare market

🧠 60%+ Ex-founders who have built, scaled, exited. We hire A-players

⚡️ Speed matters: we operate with urgency, autonomy, and ownership

🧪 You’ll work on real, first-of-their-kind problems at the edge of AI and medicine

❤️ Your work directly unlocks doctors to reclaim their time, and patients get better, faster care

Sully.ai is an equal opportunity employer. In addition to EEO being the law, it is a policy that is fully consistent with our principles. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status such as race, religion, color, national origin, sex, sexual orientation, gender identity, genetic information, pregnancy or age. Sully.ai prohibits any form of workplace harassment. 

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