Senior Engineering Manager

Were . Were building Americas national imaging network: the infrastructure that connects patients providers and payers to faster better-value diagnostic imaging. Thousands of patients move through our platform every day and each is a real person waiting for an answer to a healthcare concern. We exist to get them that answer faster.

We manage the medical imaging pathway end-to-end. Providers order through a single point of entry and from there we run the entire medical diagnostic pathway. Managing the full pathway rather than brokering pieces of it is what lets us deliver imaging faster at higher quality and at a lower cost than the fragmented status quo.

Were looking for a Senior Engineering Manager at an exciting time. Weve raised over $200m in funding to date reached profitability and are growing 100% year on year.

Millions of people wait too long for a diagnosis. Come help us fix that.

We are a small high-output team building across a complex technical surface: consumer marketplace provider-facing scheduling tools interoperability infrastructure revenue cycle tooling and AI-augmented workflows. We dont scale headcount to scale output. We scale leverage through AI-native development practices tight feedback loops and engineers who own outcomes rather than tickets.

As Senior Engineering Manager you will lead a cross-functional engineering team and remain a hands-on contributor. We expect roughly 30% of your time to be spent writing code reviewing architecture or directly shaping technical decisions. This is not a role for someone who wants to move fully into management. Its a role for someone who finds that combination energising.

You will report to our CTO and partner closely with Product Operations and Data to ship the systems that run our business. You are expected to be genuinely AI-native: not just comfortable with AI tooling but actively shaping how your team uses it. That means deploying agents building evaluation frameworks and coaching engineers to work at a level of throughput that wasnt possible two years ago.

As a scale-up business you can expect your role to develop over time. Here are some of the types of things you could be getting involved in:

• Lead and develop a team of engineers across multiple product domains owning velocity process performance technical growth and team culture

• Remain a consistent technical contributor by writing production code leading design reviews and pairing with engineers on complex problems.

• Define and enforce engineering standards across code quality system design testing discipline deployment practices and incident response

• Drive the teams AI-native operating model by identifying where AI agents can replace or accelerate engineering workflows building evaluation frameworks to measure output quality and coaching engineers to leverage AI tooling as a primary development instrument rather than an occasional aid

• Partner with Product to refine roadmaps push back on scope where necessary and ensure the team is working on the highest-leverage problems at any given time

• Own the architecture of your teams systems by making build vs. buy decisions managing technical debt deliberately and ensuring the stack can support the growth trajectory of the business

• Contribute to broader engineering culture through interview loops cross-team design reviews engineering all-hands and the institutional knowledge that makes a small team punch above its weight

1. Team command and trust. Within 90 days your team has a clear understanding of expectations a functioning operating rhythm and confidence that you are both technically credible and invested in their growth. Engineers on your team are shipping more and learning faster than before you arrived.

2. AI-native team operating model in production. You have assessed the teams current AI tooling practices identified the highest-leverage gaps and implemented a repeatable framework across agents evals and development workflows that measurably increases throughput without degrading quality.

3. Technical ownership. You have a complete grasp of the systems your team owns: their architecture observability failure modes scalability constraints and debt profile. You have a prioritized plan for the most critical improvements and have begun executing against it.

4. Meaningful individual contribution. Your 30% contributor commitment is real and visible. You have shipped production code driven at least one significant architectural decision and demonstrated to your team that you can still do the work.

5. Organizational trust. Product Operations and Data treat you as a peer. You have built the credibility to push back on scope advocate for technical investment and represent Engineering in cross-functional prioritization with authority. You are the go-to person for sequencing within large initiatives.

You dont need to tick all the boxes to apply for this role. Whether its your first role or your fifth we believe everyone can add value learn and grow. However these might be some of the ways you are currently adding value:

• Proven experience managing and growing engineering teams in a startup environment. You have operated with limited resources changing priorities and a high bar for individual output and you have thrived in that context.

• Genuine AI-native fluency: you have deployed AI agents in production engineering workflows you understand evaluation frameworks and can design them for non-trivial tasks and you have coached teams to use AI as a primary tool rather than a novelty. Candidates who cannot speak concretely to this will not be competitive

• Active technical contributor with strong engineering fundamentals. You write production-quality code in at least one modern backend or full-stack language can lead a system design discussion at a senior level and have not been out of the code for more than a year

• Experience in a scaling healthcare technology company is a strong plus. Familiarity with the regulatory environment interoperability constraints and the operational complexity of healthcare delivery meaningfully shortens the ramp

• Strong cross-functional instincts: you have partnered effectively with Product and Operations understand how to negotiate scope without burning relationships and can represent technical constraints to a non-technical audience without losing fidelity

• A track record of growing engineers. ICs on your previous teams have been promoted expanded their scope and credited you with material development in their careers

• High ownership orientation: you do not wait to be asked you do not manage up problems without a proposed path forward and you treat the business outcomes of your teams work as personally yours

At AI isnt a side project; its how we work. We expect everyone to use AI to think faster remove drudgery and multiply their output. What we care about is judgment: knowing when AI makes you sharper when it doesnt and how to use it responsibly around patient data. Well assess this in the way that matters for this role using the tier below. You dont need to be an engineer. You need to be someone who reaches for the best tool and gets more done as a result.

• Tier 1 For this role the expectation is that you are an AI-Native. You build with AI directly shipping automating or prototyping real work with LLMs and agents and have clear judgment on where humans must stay in the loop. (this is typically aligned to engineering data product ops automation RevOps)

  • You build with AI not just alongside it. Youve shipped automated or prototyped something real using LLMs agents or AI tooling.

  • You can explain a workflow you redesigned so that a machine does the boring 80%.

  • You have a view on where agentic systems help and where a human must stay in the loop especially in regulated PHI-adjacent work.

  • Assessment: A practical exercise where you use AI tools live or in a take-home.

Were building something that matters. Every scan we speed up is a real person waiting on an answer and that urgency runs through everything we do. We move fast we own outcomes and take pride in our output. If you like ambiguity working with ambitious people and want your work to visibly move the needle youll feel at home here. To be successful at you must embody our values.

Always Play Offense

If were not growing were dying. Everyone needs a bias for action. Speed and momentum combined with quality execution propel our business forward.

• You dont quit on hard problems. Fail fast dust off go again.

• You celebrate wins then seek the next opportunity.

• You see it you fix it. No task is beneath you at any level.

Build with the Best

The company we build is the team we build. If we dont have the right people in the right seats doing the right things we will fail.

• Talent recognizes talent. You actively bring quality hires into the business.

• You trust your colleagues to deliver.

• You open-source your knowledge. Youre never a single point of failure.

Care Deeply Challenge Directly

Care enough to have the hard conversations but dont dwell on them. Dont go up the chain to communicate. Go straight to the person.

• Strong opinions weakly held. You welcome challenge and feedback.

• You get to the point: direct challenge plus an alternative solution.

• You ask why. Before calling something bad understand why it exists.

Embrace Growth Be Curious

Push the limits of your understanding and potential and you will be supported to get better.

• You proactively seek feedback whatever your level.

• You invest in understanding our business: teams customers processes.

• You invest in your own growth and are willing to unlearn.

Were a high-performing team with low ego. We hire people who are brilliant and kind who give it straight back it up with evidence and change their mind when the facts change. Well give you real ownership early the tools to do the best work of your career and colleagues who raise your return we ask for high standards genuine care for patients and each other and the drive to leave things better than you found them. If that sounds like you lets talk!

We keep our interview process short and sweet and were a nimble team that can progress at pace. Here are the stages you can expect but we might switch up the order of each step depending on team availability:

1. Introductory call/interview with our Senior Talent Partner. The call is via telephone and lasts around 30 minutes.

2. Should it feel like there is an initial fit for all we will invite you to a video call with the hiring manager for around 45 minutes. This is a more structured interview that will deep-dive into the role and technical needs.

3. Scan Standard interview where our panel screens for values alignment and the success factors that matter at . You will also be assessed on your AI fluency at the stage and depth relevant to your role (see AI Requirements above).

4. Meet the founders and/or other team members. Again length varies depending on how many interviewers and whether in person or via video call.

5. Offer!

We go beyond the basics with our benefits package. We believe great work starts with supporting our people. Heres what you can expect from us:

• Salary range of $180000 - $240000

• Flexible remote or hybrid work options

• Dedicated personal development budget

• Medical vision and dental coverage

• 28 days of paid time off across PTO and wellbeing days so you can show up at your best

• Paid parental leave

• 401k retirement plan

• All the equipment you need to do your best work

• Inclusive people-first policies designed by our team for our team

is committed to eliminating discrimination and encouraging diversity within our team. We strive to provide equality and fairness for all job applicants and employees and never discriminate on the basis of gender marital status age race ethnicity religion or physical differences.

We are opposed to all forms of unlawful treatment and discrimination.

Our ambition is for our team to be representative of societys diversity and for every employee to feel respected and able to bring their best selves to work.

If you need an accommodation to apply or interview contact us at .

We look forward to receiving your application!

Required Experience:

Manager