Engineering Manager, AI Orchestrator

About the Role

Referrals are where care falls apart. A specialist referral leaves a primary care office as a fax, gets keyed into a queue by hand, waits on a phone call that nobody picks up, and lands back in an EHR days later with half the clinical context missing. Roughly a third never close the loop at all.

Orchestrator is the product that fixes this. It ingests referrals however they arrive (fax, phone, direct EHR feed), extracts the clinical and demographic data, handles outbound coordination work, and writes the result back into the EHR of record. It is a mix of document AI, voice automation, and hard integration engineering, sitting on top of a full-stack product that referral coordinators live in for eight hours a day.

We are looking for an Engineering Manager to lead the team building it. This is an existing team with a shipping product and real customers, and you will grow it meaningfully over the next year. You will own delivery, drive architecture decisions, and run your own hiring, working closely with the Director of Engineering on roadmap and prioritization.

What You'll Do

• Own delivery for Orchestrator end to end: intake pipeline, coordinator-facing application, voice automation, and EHR write-back.
• Grow the team through hiring, raising the technical bar as you do it (running loops, closing candidates, and onboarding).
• Stay technical: participate in design docs, code review, and the occasional production incident.
• Set the integration strategy: decide where to invest in durable interfaces (HL7 v2, FHIR, X12) versus where automation against the UI is necessary.
• Prepare the system architecture for the next order of magnitude in referral volume, customer count, and integrations.
• Partner directly with existing customers (health system IT, interface analysts, clinical operations leads) to translate operational requirements into technical needs.
• Turn customer conversations into a generalized product with shared abstractions rather than forking per account.
• Coach engineers into larger scope and provide direct, actionable feedback.

Qualifications

Required

• Direct experience building, shipping, and supporting software that integrates with EHR platforms.
• Working fluency in healthcare interoperability: HL7 v2 message structure, FHIR resources, and operational realities of interface engines.
• Strong full-stack engineering background with experience building and operating production services and interfaces.
• At least 1 year managing engineers, on top of 5 or more years as an individual contributor (IC) engineer.
• Comfort with ambiguity in the problem space.
• Track record of building products that serve many customers rather than bespoke one-offs.

Nice to Have

• Experience with document AI or OCR pipelines at scale.
• Experience with voice agents or telephony infrastructure (SIP, IVR navigation, real-time speech).
• Background in referral management, prior authorization, care coordination, or revenue cycle.
• Experience selling and supporting into large health systems (security reviews, integration onboarding).