Work on the most interesting boring problem in tech

Prior authorization is the invisible step between a doctor ordering an MRI and a patient getting it. It runs on faxes, PDFs, and manual review queues. Patients wait weeks for decisions that should take minutes. It is one of the most hated processes in American healthcare, and for the first time, it's actually solvable.

The defining companies of the last two decades were built on unglamorous rails: payroll, freight, payments. Prior authorization has the same shape. We build AI agents that read medical records and process authorization requests end to end in production, with clinicians holding the final decision. And prior auth is only the wedge: the endgame is healthcare's entire administrative layer, run by agents, so humans can spend their time on care instead of paperwork.

Traction

• ARR up 15× since January 1
• 6M+ patients touched by our platform, on track for tens of millions by year end
• Live in production: not a demo, not a pilot. Our agents' work stands up to clinical and regulatory audit today.
• Backed by Maverick Ventures, firstminute Capital, and Entrepreneur First
• Founded by Alex (open source and insurance: Linux Foundation, RGA) and Hermine (MIT AI researcher, healthcare)

The work, by role

• Engineering: Most AI products tolerate a 5% error rate. Ours can't. Long-horizon agent workflows inside legacy healthcare infrastructure, evaluation at a bar most of the industry never faces, and human-in-the-loop systems where trust is the product. Anyone can build an agent that books a restaurant. We build agents whose work gets audited.
• Customer & GTM: You'll sell and support something healthcare already desperately want killed: the fax queue. The hard part isn't demand, it's earning trust inside regulated organizations. You'll work directly with clinical and operating teams and see your deals change how real cases move within weeks.
• Clinical: You've seen the impact of having delayed access to care can have on patients and colleagues. Here, your clinical judgment becomes the standard tens thousands of determinations are held to everyday . Clinicians don't advise the product, they hold the final decision in it.

How we work

You own problems end to end. Some of the workflows we're expanding into don't exist as products yet, you could take one from whiteboard to production. You'll ship in your first weeks, sit in calls with the people using what you build, and watch your work change real cases the same week. Everyone holds meaningful equity.

• Location: In person in San Francisco.
• Compensation: Competitive salary and meaningful equity, set by role, see each role page for the range.

Should you apply?

We'd rather you self-select out than waste your time. This isn't the right place if you need a complete spec before starting or prefer not to talk to customers.

You'll thrive here if you think from first principles, kill your own ideas fast, push back when requirements don't make sense, and are motivated by the fact that the thing you ship gets a patient their care sooner.