Founding Engineer

American healthcare providers spend hundreds of billions a year creating and optimizing health insurance claims. Payers spend a similar amount adjudicating them.

AI was supposed to fix this, but really it's making things worse. Providers use AI to improve claims; payers deploy AI to deny them. Both sides spend more; neither gains. So we're collapsing the middle of this negative-sum system and building the infrastructure that makes healthcare billing deterministic.

We're converting payer policies and medical notes into computable contracts grounded in formal logic - exposed via API and MCP, evaluated at the point of care, optimized for token efficiency, latency, and accuracy. We're replacing the adversarial back-and-forth between providers and payers with transparent, auditable, pre-agreed rules.

When we succeed, we'll materially reduce the cost of care for the American patient.

About us

On September 18 we announced a $100 million commitment led by our new partners at Thoreau, alongside our existing investors Bertelsmann Healthcare Investments, Twine Ventures, and Seedcamp.

Ten months ago this company was two people and a question: will my insurance cover this procedure? Now we are hiring across New York and London to become the intelligence platform both sides of American healthcare build upon.

Our angels include Dane Knecht (Cloudflare CTO), Lord Ara Darzi, and the Head of Microsoft AI Health. Tech stack: Python, Railway, AWS, Prefect, LakeFS, LLMs with Pydantic AI and evals.

What You'll Work On

You'd be a founding engineer on our team. The things you'll work on include:

Designing the ingestion engine that tracks constantly-updating coverage policies across thousands of payers — combining web scraping, LLM-powered extraction, and structured validation.

Building the representation layer that converts medical necessity criteria into computable contracts (think: formal logic, CQL, deterministic evaluation).

Architecting the API and MCP endpoints that let AI agents query coverage rules at low latency and high accuracy, at scale.

Shaping technical decisions that will define the company's architecture for years.

What We're Looking For

You have 3+ years of experience and are able to perfectly balance speed vs. quality when shipping

You enjoy taking end-to-end ownership of a problem which is not perfectly defined.

You ship for the user!

You have strong technical skills, ideally backend.

What We Offer

• London, in-office 5-days a week (with some flexibility)
• Lunches at the office: Wild Wednesday's (pitch crazy ideas), Friday lunch & learn (can be any topic)
• Dinner covered if staying late
• Budget for anything that will make your life easier or more efficient/pleasant.
• The chance to shape the technical foundation of a company building core infrastructure for a $200B+ market

We also offer a $10k referral bonus (after the referred hire finishes a 3 month probation period). Penelope Health is an equal opportunity employer. We consider all qualified applicants without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, veteran status, or any other characteristic protected by law.