NxT Level

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Senior Software Engineer (Agentic AI / Healthcare) Location: New York, NY (Manhattan), Hybrid (3 days onsite) Compensation: $150,000-$250,000 base + equity Contact / Apply: Ryan Johnston - ryan@nxtlevel.io About Our Client Our client is a venture-backed healthcare technology company based in New York and Toronto, building agentic AI solutions that reimagine how medications are prescribed, verified, and supported across the pharmacy ecosystem. Backed by $4M in funding and trusted by multiple Fortune 50 healthcare organizations, they're scaling quickly and expanding their AI product line. As an early engineering hire, you'll play a meaningful role in shaping architecture, shipping production systems, and balancing speed with quality. The work directly impacts pharmacy workflows and, most importantly, patient outcomes. Mission Our client is building a world where medication delays are impossible. From the moment a prescription is written, the path to therapy start should be clear, fast, and predictable. Their platform connects the fragmented steps that slow medication access, intake, coordination, utilization management, and clinical services, so patients start therapy sooner. The Role Our client is hiring a Senior Software Engineer to design and build autonomous, agentic systems that run complex, multi-step pharmaceutical workflows end-to-end. This is a backend-leaning role with broad scope: you'll work across orchestration, integrations, reliability/observability, and the practical realities of healthcare systems. This role is ideal for someone who enjoys ambiguous problems, can ship end-to-end, and wants to build real product in a regulated, high-stakes domain. What You'll Do - Design and build autonomous agents that handle multi-step pharmacy workflows end-to-end - Architect communication systems that coordinate across organizational boundaries (providers, payers, pharmacies, vendors) - Build orchestration layers for long-running tasks, including graceful failure handling and human-in-the-loop escalation - Develop frameworks enabling agents to interact with external pharmacy systems, databases, and APIs - Implement evaluation + observability infrastructure to monitor agent behavior in production (quality, drift, failure modes) - Integrate with healthcare data standards and legacy pharmacy systems - Scale systems for real-time processing across multiple pharmacy networks What Our Client Is Looking For Must-Have Qualifications - 5+ years of software engineering experience with a strong backend focus - Proficiency in Python or TypeScript and deep backend fundamentals (APIs, data stores, concurrency, distributed systems) - Experience with service-oriented architectures and web frameworks (FastAPI, Flask, or equivalent) - Strong API design skills (clean, versioned APIs) - Familiarity with caching, messaging, and databases (e.g., Redis, Kafka, SQL/NoSQL, vector databases) and how to apply them for performance and reliability - Cloud experience (Azure, AWS, or GCP) - Experience building and deploying agentic AI systems, including tool use, planning, memory, and orchestration patterns - Proven ability to ship ambiguous projects end-to-end with minimal guidance and own outcomes - Based in NYC and able to commute to Manhattan 3 days/week Nice-to-Haves - Experience integrating with healthcare/pharmacy systems or healthcare data standards - Experience building evaluation harnesses for agent reliability and hallucination mitigation - Prior work in regulated environments where correctness and auditability matter Compensation & Perks - Competitive compensation: $150k-$250k base + stock options - Full medical, dental, vision coverage - Unlimited PTO + 2 weeks company-wide holiday closure - Complimentary breakfast daily and weekly team lunches (in-office) - Professional development stipend Why This Role This is a rare opportunity to be early, own architecture, and build agentic systems that directly improve medication access-where execution quality matters and the impact is tangible.