Senior AI Engineer — Voice & Agentic Systems

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.