Founding Applied AI Lead

About Paxos Health

Paxos Health is a Seed-stage healthcare AI startup that has raised >$6M in venture capital funding, with AI agents already operating in production with customers. Our founding team comes from Stanford, Meta, Microsoft, Medtronic, Columbia, University of Waterloo, and has founded previous startups and healthcare nonprofits.

We are building the AI-native operating system for getting patients access to the medical technologies their doctors prescribe. Too often, even when a physician decides a patient needs a healthcare product (cancer tests, genetic diagnostics, prosthetics, heart valves, neurostimulation devices, home medical equipment, etc.), health insurance companies deny coverage, and breakthrough technologies struggle to reach the people they were built to help.

We help healthcare manufacturers fight for coverage patient-by-patient. Before LLMs, this work was too difficult to use AI technology for, and human teams were forced to cut corners to get through all of the patient cases. But now, AI can help manufacturers meet increasingly complex insurer requirements and get more patients access to care.

About the Role

Paxos Health is looking for a hands-on Founding Applied AI Lead. You'll work directly with the founders and help define the applied AI function at a seed-stage company before the playbook exists. (Note that the job title itself is flexible based on candidate preferences.)

The challenge is turning probabilistic LLM behavior into reliable, auditable workflows that customers trust in production. We've succeeded with the customers we've had so far, and we want to scale our AI to many more.

This role is deeply hands-on, but the core output is not production backend code. It is the written and structured system design layer around our AI: precise agent instructions, workflow specs, output schemas, implementation playbooks, and decisions about how messy customer processes should be translated into reliable product behavior.

As an early employee, there is a significant opportunity to grow the scope of your role. For example, you could become more product-adjacent, or more engineering-adjacent, depending on your interests.

We are open to many backgrounds for this role, not just software engineering. For example, a strong senior technical writer can be a great fit for this role. Much of the work is about precise instructions, structured outputs, reusable specs, and customer-facing implementation logic. If you have owned complex documentation systems, API or developer docs, information architecture, docs-as-code workflows, or cross-functional technical content, this role applies those same skills to AI systems in production.

Responsibilities

You will own the applied-AI layer of Paxos’s customer workflows. In practice, your work will include:

• Designing AI workflows from messy real-world processes: translate customer reimbursement workflows into clear system behavior, including inputs, outputs, decision rules, edge cases, escalation paths, and human review steps.
• Writing and improving agent instructions: create prompt/instruction sets that help agents extract clinical facts, apply payer policies, cite evidence, identify missing information, and generate reviewer-ready prior authorization or appeal content.
• Creating reusable implementation playbooks: turn customer-specific learnings into clear internal specs, templates, QA checklists, reviewer guidance, and implementation patterns that help Paxos scale beyond one-off customer builds.
• Defining structured outputs: design schemas, evidence tables, decision trees, missing-information checklists, and reviewer-facing summaries that make AI outputs reliable, auditable, and easy to evaluate.
• Building evals and QA processes: create test cases, eval sets, quality rubrics, and failure-review loops so we can measure and improve workflow performance over time.
• Debugging AI workflow failures: inspect outputs, identify why an agent missed evidence or followed the wrong logic, and turn those findings into improvements to prompts, schemas, workflow design, or product behavior.
• Working directly with customers during implementation: clarify requirements, understand edge cases, validate outputs, and turn customer-specific learnings into reusable Paxos capabilities.
• Helping shape Paxos’s AI roadmap: contribute to our strategy for document workflows, voice AI, computer-use agents, automated prompt-writing, and other applied-AI systems.

For example, you might take a payer policy and customer cases, turn them into a structured decision workflow, write the agent instructions, design the output schema, build evals, review failures, and work with engineering to productionize the workflow.

This is not a pure software engineering role. If you have a software engineering background, you can write some production code, but that will not be a majority of the role.

Requirements

• Minimum 2+ years of work experience in any one of the following (wide variety of fields): forward-deployed engineering, technical writing, software engineering, AI operations, legal work, software QA at AI companies, or related work.
• Extreme detail-orientation: you notice edge cases, inconsistencies, missing requirements, and quality issues that others overlook.
• Communication skills: strong English written and verbal communication. Comfortable interacting directly with enterprise customers.
• Strong interest in Applied AI: you use LLMs regularly and are excited to apply them to complex real-world workflows. You do not need to have been an AI engineer.