firsthires.liveUpdated 29 min ago
For companiesLoading open roles.
Early · 19 people
Opens jobs.ashbyhq.com in a new tab. You apply with Decoda Health directly; firsthires.live never sees your application.
Opens jobs.ashbyhq.com. You apply with Decoda Health directly.
Decoda Health · Full-time · Toronto
Decoda is the all-in-one, AI-native operating system for modern elective-care clinics — med spas, wellness, longevity, and aesthetics practices. Most clinics run on 5–10 disconnected tools that don't talk to each other; we replace all of them with a single platform: scheduling, charting, billing, payments, memberships, inventory, and patient communication in one place, with AI built into every workflow — an AI front desk that books patients 24/7, an ambient scribe that writes clinical notes in real time, and automated follow-ups that keep calendars full.
We're a Y Combinator (S23) company. We're live in 200+ clinics, processing $150M+ in annual transactions, and we've grown more than ten-fold in the last six months. We're a small team that has consistently out-shipped incumbents many times our size. The team is small by design.
We believe AI should expand what one person can do, not just speed up what they already do. Every engineer here works with coding agents as a core part of the job: agents take on the implementation, and you bring the judgment: what to build, how it should be designed, and whether it's actually right. That's how a small team ships a platform this broad and keeps it trustworthy for clinics that depend on it every hour.
We want engineers who are excited by that leverage and take full ownership of what they ship, whoever or whatever typed it.
As an early engineer at Decoda, you own meaningful surface area from day one. You'll work across the stack to ship product that clinic staff use every hour of every day — and that directly moves revenue, patient experience, and clinical efficiency for our customers. This is a build-and-own role: you'll scope problems, talk to users, write the code, ship it, and watch how it lands.
Because we're small and the platform is broad, the work spans real-time patient communication (voice, text, and document), payments and billing infrastructure, EMR workflows like charting and scheduling, and the AI agents that sit on top of all of it. You won't be boxed into one corner of the codebase.
Design, build, and ship full-stack features end-to-end — from data model to API to UI — that clinics rely on daily.
Build and harden the infrastructure behind payments, patient messaging, and clinical documentation, where correctness and uptime are non-negotiable.
Integrate and productionize AI capabilities (agents, ambient scribing, automated follow-ups) into real clinical and front-desk workflows.
Work directly with customers and the founders to turn ambiguous problems into shipped product, often within days.
Own quality: write tests, instrument what you ship, and fix things fast when they break.
Help set the technical foundations — patterns, tooling, and standards — that the next 20 engineers will build on.
3+ years building and shipping production software, ideally at a startup or on a small team where you owned features end-to-end.
Strong fundamentals in a modern backend language and a typed frontend stack; comfortable moving across the full stack.
Solid grasp of data modeling, APIs, and relational databases (SQL).
A bias for shipping — you'd rather get something real in front of users and iterate than polish in isolation.
Comfort with ambiguity and a sense of ownership; you treat "is this someone's job?" as "this is my job."
Clear written and verbal communication, and a genuine interest in talking to the people who use what you build.
Experience in healthcare, fintech/payments, or another regulated, high-trust domain.
Hands-on work integrating LLMs or AI agents into production products.
Familiarity with cloud infrastructure (GCP), containerization (Docker/Kubernetes), and CI/CD.
Real-time systems experience (voice, messaging, event-driven architectures).
Early-stage startup experience and a track record of high output with a small team.
Leverage. AI gives tiny teams massive reach. Your code ships to 200+ clinics and shows up in real revenue and saved hours.
Ownership. You'll have outsized influence on the product, the architecture, and the culture this early.
Momentum. A growing, profitable-trajectory business in a category we're positioned to define, backed by YC.
Real impact. You're freeing clinical teams from busywork so they can focus on patients.