Senior IT Systems Engineer

Cadence is the clinical AI company automating the treatment of chronic disease. Its Clinical Intelligence takes on the routine, high-volume work of chronic care – monitoring patients, surfacing risks, and coordinating action – so clinicians can focus on the decisions that require them. Grounded in partnerships with more than 20 leading health systems, deep EMR integrations, dedicated medical group, and experience serving a population of more than 100,000 patients, the system learns from real-world care delivery, improving as it scales. Cadence has been recognized by TIME as one of the Top 100 HealthTech Companies and by LinkedIn as a Top Startup (#4, 2025).

The Role

We’re hiring a Senior IT Systems Engineer to build and operate the identity, endpoint, and SaaS infrastructure that supports Cadence’s clinical and operational teams. You’ll use code, APIs, and AI-powered automation to make our systems more secure, reliable, and scalable as we grow.

This is a hands-on engineering role with ownership from design through deployment and ongoing operation. AI will be central to how you work, from accelerating development and troubleshooting to building intelligent workflows. You’ll turn manual processes and recurring problems into maintainable systems, partnering closely with IT Operations, Security, and teams across the business.

What You'll Do

• Design, build, and own automation and API-driven integrations across Okta, Google Workspace, Slack, and other critical SaaS platforms to reduce manual work and improve reliability.
• Use AI-assisted development tools and LLM APIs to build and improve operational workflows, applying appropriate permissions, testing, monitoring, and human review.
• Build and scale identity lifecycle automation across employee onboarding, role changes, and offboarding, including provisioning, access controls, and timely deprovisioning. Partner with Revenue Operations on Salesforce access management, including permission sets and role-based access.
• Engineer automated device enrollment, configuration, software deployment, patching, and compliance workflows across our macOS and iOS fleet.
• Partner with Security to strengthen endpoint protections and secure access, automate security controls and evidence collection, and support audit readiness.
• Build reliable, maintainable systems through version control, code review, testing, and infrastructure as code, with clear documentation, monitoring, alerting, and recovery.
• Own complex technical projects and cross-system escalations from investigation through resolution, addressing root causes through automation and translating business needs into solutions that balance delivery speed, security, and reliability.

What You Need

• 5+ years of experience in IT systems engineering, technical operations, or a related engineering role, with a track record of independently building and operating automation. Experience in a startup or high-growth environment is a plus.
• Practical experience using AI-assisted development tools as part of your engineering workflow and integrating LLM APIs into tools or automation. You can evaluate output quality, protect sensitive data, scope permissions, and determine when deterministic logic or human review is needed.
• Strong programming skills in Python, TypeScript, or a comparable language, with experience using Git-based development workflows and Terraform or similar infrastructure-as-code tools. Examples of tools, integrations, or open source projects you’ve built are welcome.
• Experience administering SaaS platforms such as Google Workspace, Slack, and Zoom and building REST API integrations, webhooks, and event-driven workflows using code, automation platforms such as Okta Workflows or Tines, or both.
• Strong knowledge of identity and access management, including hands-on experience with Okta, SAML, SCIM, OIDC, automated provisioning, and least-privilege access. Familiarity with Salesforce permission sets, permission set groups, and access controls is a plus.
• Hands-on experience managing macOS and iOS fleets through MDM platforms such as Kandji, Iru, or Jamf, including configuration, software deployment, patching, and device compliance. Experience with Netskope or Santa is a plus.
• Strong networking and security fundamentals, including DNS, TLS, VPNs, firewalls, Zero Trust access, and secure handling of credentials and sensitive data, with the ability to troubleshoot across systems independently. Experience supporting audit readiness for SOC 2, ISO 27001, HIPAA, or similar requirements is a plus.

CompensationOur job titles may span more than one career level. The base salary for this role typically ranges between $175,000 – $200,000 depending on experience, skills, seniority, and business needs. In addition to base salary, this role may be eligible for equity as part of the total compensation package. Actual compensation may vary by location.

Benefits & Perks

• Competitive pay & equity*
• Fully remote
• Comprehensive health coverage: Medical, dental & vision
• Paid time off
• 401k plan + matching
• Paid parental leave
• Home office stipend

*benefit offerings may vary depending on job profile, job level and worker type

Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws. 

A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team.  Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.

If you require a reasonable accommodation during the interview or hiring process, please notify your recruiter.