Software Engineer

Nestmed
San Francisco, CA
On-site

Who this role is best for

Aimed at mid-to-senior full-stack engineers who can build and own AI-powered healthcare systems, with a focus on product ownership and cross-platform development.

Best fit for

  • Candidates with experience in building mission-critical healthcare software and AI integration
    — “You've built something people depended on, where getting it wrong had real consequences”
  • Individuals who have worked at a startup and can drive decisions without detailed specs
    — “You've worked at a startup and can decide what to do without a spec”
  • Engineers with strong product sense and the ability to translate user needs into technical solutions
    — “Product sense: you listen closely to users, go deep on their problems, and translate what they need into the right technical decisions”

Things to consider

  • The role demands full-time commitment and may require working across multiple platforms and industries
    — “Work wherever the problem is: the Django and Postgres backend, the web app, or the native iOS and Android apps”

How to stand out

  • Highlight your experience with AI agents and multi-step workflows in regulated environments
    — “LLM products in production: evaluations, multi-step model workflows, agents”
  • Showcase your ability to own features from start to finish, including user interaction and deployment
    — “Own features from start to finish. You'll talk to clinicians and agency leaders, decide what to build, ship it, and watch it run across hundreds of thousands of visits a day.”
  • Emphasize your experience with HIPAA, HL7/FHIR, or similar healthcare standards
    — “Experience in healthcare or another regulated industry (HIPAA, HL7/FHIR)”
  • Demonstrate your ability to work with audio processing and real-time systems
    — “Audio, real-time systems, or mobile apps that work offline”
Pace · Fast PacedCollaboration · HighAutonomy · HighDecision Impact · Team

Derived from job-description analysis by Serendipath's career intelligence engine.

What success looks like

  • building core data models
  • integrating AI agents
  • connecting to medical record systems
Typical background
software engineeringAI development

Skills & requirements

Required

Full-stack DevelopmentAI IntegrationProduct SenseClinician CommunicationEnterprise Integration

Preferred

Healthcare ExperienceHipaa ComplianceLLM ProductsAudio ProcessingReal-time Systems

Stack & domain

PythonDjangoPostgreSQLTypeScriptReactSwiftKotlinAWSAudioReal-time SystemsMobile AppsProduct SenseClinician CommunicationProblem SolvingDecision MakingPost-acute CareAi-native Operating SystemHome HealthHIPAAHl7/fhir

About the role

Original posting from Nestmed via Ashby

Nestmed is building the AI-native operating system for post-acute care.

Millions of Americans get care at home every year. The agencies delivering it run on decades-old software, disconnected tools, phone calls, and faxes, with nothing that ties the work together.

We started with the hardest piece: understanding what actually happens in the visit. Now we're building everything on top of it, so an entire agency runs on one intelligent system.

7 of the 10 largest home health companies in the US already run on Nestmed, across hundreds of thousands of visits a day. We closed our Series A, backed by investors including Max Levchin, co-founder of PayPal, and veterans of the home care industry.

What you'll do

  • Build the operating system itself: the core data model and workflows that every part of an agency runs on, including patients, visits, orders, coding, QA, and billing.
  • Build AI agents that do real clinical and operational work end to end, with clinicians kept in control.
  • Build AI-powered product that clinicians rely on in the middle of patient care, where accuracy and speed both matter. For example, turning visit audio into structured clinical data that drives everything downstream.
  • Own features from start to finish. You'll talk to clinicians and agency leaders, decide what to build, ship it, and watch it run across hundreds of thousands of visits a day.
  • Connect to the medical record systems our customers depend on, and build the enterprise basics large health systems require: single sign-on, account provisioning, and audit trails.
  • Work wherever the problem is: the Django and Postgres backend, the web app, or the native iOS and Android apps.

What we're looking for

  • 3+ years building and shipping product, with solid full-stack fundamentals.
  • You use AI heavily in how you write software.
  • You've worked at a startup and can decide what to do without a spec.
  • Product sense: you listen closely to users, go deep on their problems, and translate what they need into the right technical decisions.
  • You've built something people depended on, where getting it wrong had real consequences.

Bonus

  • Experience in healthcare or another regulated industry (HIPAA, HL7/FHIR).
  • LLM products in production: evaluations, multi-step model workflows, agents.
  • Our stack: Python/Django, Postgres, TypeScript/React, Swift or Kotlin, AWS.
  • Audio, real-time systems, or mobile apps that work offline.

If you want to build the system an entire healthcare industry runs on, we'd love to hear from you.

Source: Nestmed careers (Ashby)

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