Director, Engineering

Director Engineering

Fold Health Pune India (In-Office) Full-Time

Experience: 12-18 Years Reports to: VP Engineering

Domain: US Healthcare (Value-Based Care / Population Health / HealthTech preferred)

About Fold Health

Fold Health is building an AI-powered orchestration platform for value-based care. We dont just analyze healthcare data; we enable AI agents to execute complete workflows across care delivery from patient outreach to claims processing to care coordination.

We process and normalize diverse healthcare datasets (EHR claims ADT CRM transactional and third-party sources) into a unified data model that powers advanced analytics AI/LLMs and BI. Our customers include IPAs ACOs national enablers health systems MSOs and payers across the US.

We are a well-funded startup backed by leading investors building in Pune for the US healthcare market. This is a high-ownership high-impact role where you will shape engineering culture architecture and team from the ground up.

The Role

We are looking for a Director of Engineering to own and scale Fold Healths engineering organization from our Pune office. This is not a maintenance role. You will be building: building teams building architecture building processes and building a culture of engineering excellence for a platform that directly impacts patient outcomes.

You will operate with significant autonomy during India hours partnering closely with US-based product data and business leadership across time zones. You will own engineering delivery end-to-end while collaborating on product strategy and technical vision.

What You Will Own

Engineering Leadership and Team Building

• Define and execute the engineering roadmap aligned with product and business strategy
  

• Lead and grow multiple engineering teams across:
  

• Backend microservices ( / NestJS)
  

• Frontend (ReactJS React Native)
  

• Python-based services and AWS Lambda functions
  

• Data pipelines (GCP FHIR Store BigQuery Postgres)
  

• Scale the Pune engineering team from current state to 25 engineers; own hiring retention and performance
  

• Establish engineering career ladders performance frameworks and a culture of ownership and accountability
  

• Mentor Engineering Managers and Tech Leads to build leadership depth
  

Architecture Platform and Reliability

• Own architecture decisions across a dual-cloud environment (AWS GCP)
  

• Drive reliability scalability and high availability of distributed systems
  

• Optimize healthcare data ingestion pipelines: FHIR HL7 X12 EDI (837/835) ADT feeds
  

• Manage cloud spend make build-vs-buy decisions and evaluate vendor partnerships
  

• Strengthen observability monitoring alerting and incident response across time zones
  

• Reduce technical debt systematically while maintaining delivery velocity
  

Healthcare Compliance and Security

• Ensure HIPAA-compliant architecture and PHI/PII data security practices
  

• Drive HITRUST certification readiness and SOC 2 Type II compliance
  

• Oversee EHR integrations (Elation Athena eCW Epic Cerner etc) HIE feeds claims pipelines and CRM integrations
  

• Implement and enforce access control audit logging encryption and vulnerability management
  

AI and Product Innovation

• Partner with AI/ML teams to productize LLM-powered healthcare agents that execute real workflows (not just analytics)
  

• Enable feature engineering pipelines and analytics infrastructure for care coordination and population health
  

• Evaluate emerging healthcare AI technologies to maintain competitive edge
  

Operational Excellence

• Improve SDLC maturity: CI/CD automation testing culture code review standards DevOps practices
  

• Define and track engineering KPIs: velocity quality reliability and developer experience
  

• Own incident management root cause analysis and production support processes
  

• Manage engineering budget cloud infrastructure costs and vendor relationships
  

Requirements

• 12-18 years of hands-on software engineering experience with 5 years in senior engineering leadership (Director / Sr. Manager level)
  

• Proven experience building and scaling engineering teams (20 engineers) in a product company
  

• Strong distributed systems and microservices architecture background
  

• Deep experience with:
  

• (NestJS

  Required Skills:

  12-18 years of hands-on software engineering experience with 5 years in senior engineering leadership (Director / Sr. Manager level) Proven experience building and scaling engineering teams (20 engineers) in a product company Strong distributed systems and microservices architecture background Deep experience with: (NestJS preferred) ReactJS / React Native Python PostgreSQL and large-scale data systems (BigQuery data warehousing) AWS and/or GCP cloud platforms containerization (Docker Kubernetes) Experience in healthcare fintech or other regulated platform environments Strong understanding of HIPAA compliance security best practices and data governance Experience with FHIR standards HL7 or X12 EDI is strongly preferred Comfortable with cross-timezone collaboration (US business hours overlap required) Excellent system design thinking and the ability to communicate architecture decisions to both technical and non-technical stakeholders 5 years working with value-based care risk-based arrangements or population health programs Proven ability to lead cross-functional teams without direct authority Strong executive presence with experience engaging C-level and clinical leaders Comfortable operating in high-growth ambiguous environments Willingness to travel to customer sites as needed

  
  

  Required Education:

  Bachelors or Masters degree in Computer Science Software Engineering or related HaveKnowledge of MLOps continuous evaluation pipelines or model integrating AI features into SaaS or API-first exposure to healthcare AI clinical NLP or population health analytics