The work is administrative. The leverage is not.
Praxa builds AI operators that execute administrative work inside US health systems. We are early, we are onboarding design partners for 2026, and we are hiring a small number of people who would rather own a problem than a ticket.
Right now, somewhere in a hospital, a person is reading a fax, keying it into an EHR, opening a payer portal, and waiting on hold. Tomorrow a different team will re-verify what they entered.
It is not a glamorous problem. There is no consumer app at the end of it. What there is: an enormous volume of work nobody chose, sitting directly on top of a health system’s margin and its capacity to see patients.
If you want a problem where correctness is verifiable, where the user is on the call with you, and where shipping something that works changes somebody’s Tuesday — this is that problem. It is also slow, detailed, and occasionally tedious. Both things are true.
- What you’ll be near
- Real revenue-cycle teams, real queues, real backlogs. Not a benchmark, not a sandbox.
- What makes it hard
- The inputs are messy, the systems of record are hostile to automation, and being mostly right is the same as being wrong.
- What we won’t claim
- That this is a calling. It is a hard, useful, commercially serious problem. That should be enough.
The working model, stated plainly.
Adjectives are cheap and every company claims the same five. Here is the actual shape of the job.
If any of this reads as a bad fit, it probably is — and we would both rather find that out in the first conversation than the fourth.
- Team shape
- Small enough that everyone can say what everyone else shipped this week. You will not be the fourth engineer assigned to a feature, and there is no layer between you and the decision.
- Forward-deployed
- Engineers sit with design partners. You will be on calls with the person whose queue you are automating, watching them work the old way, and building against what you saw rather than a spec written by someone who wasn’t in the room.
- Ownership
- You own a workflow end to end: extraction, execution, the evaluation harness, the failure modes, and the conversation when it breaks at 7am. Handoffs are where this category of work goes wrong, so we keep them few.
- Evidence over demos
- Nothing reaches a live queue without a harness that measures it against labelled cases and a documented rollback. “It looked right in the demo” is not a result anyone here will accept from you, and you should not accept it from us.
- Writing
- Decisions get written down — short documents, honest trade-offs, a record that still makes sense in six months. Meetings are for the things writing cannot settle.
- Where and when
- Remote-first across US time zones, with a real overlap window so the day is collaborative rather than asynchronous by default. Some roles include on-site time at partner health systems; we will tell you how much before you have to decide anything.
Five roles. Each one owns something.
- 01
Clinical / Revenue Cycle Domain Lead
You have actually run a revenue cycle department. You will decide which workflows we build, in what order, and what “correct” means for each one — then hold the product to it.
- 02
Forward-Deployed Engineer
Own a design-partner deployment end to end: integration, workflow build, go-live, and the escalation when a queue backs up on a Monday morning.
- 03
ML Engineer, Document Understanding
Extraction from scanned, faxed, and half-legible clinical and payer documents — and the evaluation harnesses that tell us honestly whether it works.
- 04
Security & Compliance Lead
Build the security and compliance program from the first control onward — access model, audit evidence, vendor review, and the answers a health system CISO will actually accept.
- 05
Founding Product Engineer
The operator console, the audit trail, the exception queues — every surface where a person sees what the system did and corrects it. Design taste required, not optional.
A process that fits on one screen.
Five stages, published timing, and a paid work sample instead of an unpaid take-home. You will know where you stand after every one of them, including when the answer is no.
If any stage does not work for your situation — schedule, caregiving, accessibility, work authorisation, or a current employer you would rather not alert — say so in the first call. We will adjust the format, not the bar.
- 01Intro call
- 02Technical or domain conversation
- 03Paid work sample or deep dive
- 04Team conversations
- 05Decision and offer
Early-stage benefits, described without inflation.
- 01
Equity, explained
Every full-time offer includes equity. We walk through the share count, the strike, the total outstanding, and what it would and would not be worth — before you ask.
- 02
Health coverage
Medical, dental, and vision for you and your dependents. The specific plans and the company contribution go in writing with the offer, not after you accept it.
- 03
Time off you take
Paid time off plus US public holidays, with a minimum you are expected to use. A policy that only works when nobody uses it is not a policy.
- 04
Parental leave
Paid leave for birth, adoption, and foster placement, on the same terms for every parent. Written down, and shown to you before you sign anything.
- 05
Equipment and workspace
The machine you actually want and a budget for a setup that does not wreck your back. Ask once; it gets ordered.
- 06
What we don’t have yet
We are early. Several programs a large employer offers as standard — formal L&D budgets, a 401(k) match, an internal mobility ladder — do not exist here yet. We would rather say that now than have you discover it in month three. Ask in the intro call and you will get the current, unedited list.
Deliberately absent from this page: dollar amounts, equity percentages, named insurance carriers, and day counts. Those are real numbers, they are specific to the role and the year, and you will get them in writing rather than in marketing copy.
Nothing above fits? Write anyway.
If you have spent years inside a revenue cycle department, or you build systems that have to be right in front of people who will notice when they are not, we want to read it. One honest paragraph on what you would want to own beats a cover letter, and we would rather create the right role than fill the wrong one.
Email careers@praxaai.ai