Sully.ai

Head of Engineering

San Francisco, US Full-time

About Us

At Sully.ai, We’re Building the Most Impactful Healthcare Company on Earth

We believe that access to a great doctor is a basic human right. Today, that’s not a reality. Delays, misdiagnoses, administrative chaos, and burnout plague the system.

Our Mission: One Human, One Doctor. We build AI teammates that augment clinicians — scribes, nurses, receptionists, translators — all powered by our own world-class models and deployed in real-world care.

Our Traction

  • 450+ organizations signed 16 months
  • AI agents cut admin by ~2.8 hours daily and reduce onboarding 85%.
  • 5M+ Clinical Tasks completed to date, serving 36+ specialties.
  • Raised $25M from YC, Eric Yuan, Amity, Semper Virens
  • Patented AI architecture (MedCon-1) outperforms GPT-4.5, Gemini, Claude on clinical reasoning tasks

Sully requires A-players capable of 4 months = 1 year output.

What You’ll Do:

We are hiring multiple Heads of Engineering to own and scale core product domains: Scribe, Consultant, Integrations, and Platform. Each role has full technical and execution ownership for its surface area.

  • Own end-to-end engineering execution for your domain, from architecture and roadmap through delivery and reliability.
  • Drive step-function latency reductions, targeting at least 50 percent improvements across note generation and decision-support workflows where applicable.
  • Design and operate robust observability, metrics, and model-selection systems to ensure consistent performance at scale.
  • Lead domain-specific execution rituals including daily and weekly standups, backlog ownership in Linear, and tight cross-functional coordination.
  • Translate product goals into clear dependencies, timelines, and deliverables to keep teams unblocked and shipping.
  • Operationalize continuous quality evaluation pipelines to improve accuracy, completeness, and reliability of outputs.
  • Set and enforce engineering best practices across your stack, including code quality, reviews, on-call standards, and operational rigor.

What You Must Bring

  • Founder-level ownership mindset. You operate like the business depends on your decisions and execution.
  • Senior, hands-on engineering ability. You actively design systems, write and review production code, and set the technical bar by example.
  • Experience in high-intensity environments such as YC-backed startups, early-stage companies, or zero-to-one teams where speed and judgment matter.
  • Strong systems thinking with a proven record of improving latency, throughput, and reliability in real production systems.
  • Comfort with ambiguity. You turn incomplete product direction into clear technical plans and ship without heavy process.
  • High quality standards. You enforce clean abstractions, disciplined reviews, and operational rigor while moving fast.
  • Bias toward leverage and simplicity. You choose durable solutions and know when to optimize versus when to ship.
  • Clear communicator who can align engineering, product, and leadership with minimal overhead.
  • Nice-to-have:
    • Experience with FHIR/HL7 or EHR systems.
    • Background in real-time or near-real-time streaming, diarization, or structured-output pipelines.
    • Experience supporting front-end or extension-based integrations (web, mobile, browser extension).

First-Month Focus

  • Take full ownership of the assigned engineering domain.
  • Ensure end to end observability and alerting for core workflows.
  • Define the domain’s key performance, reliability, and quality metrics.
  • Identify and ship at least one high impact improvement.
  • Establish execution cadence, priorities, and quality standards.

If you’ve ever said, “I want to do work that actually matters”, this is it. Let’s build something life-changing, together.

Who Thrives Here

  • Entrepreneurial to your core: You think in outcomes, thrive in chaos, and take ownership without limits
  • Mission-obsessed: You’re here to save lives, not just ship features — patients and doctors are your why.
  • Impact-driven & fast-moving: You sprint toward hard problems and ship with sharp judgment.
  • Elite teammate: You raise the bar through high standards, direct feedback, and craft excellence.

Why Join Sully.ai?

🔥 Revolutionizing the antiquated $800B+ Healthcare market

🧠 50%+ of us are ex-founders. We hire A-players, not passengers

⚡️ Speed matters - we operate with urgency, autonomy, and ownership

🧪 You’ll work on real, first-of-their-kind problems at the edge of AI and medicine

❤️ Your work helps doctors reclaim their time - and patients get better, faster care

Sully.ai_ is an equal opportunity employer. In addition to EEO being the law, it is a policy that is fully consistent with our principles. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status such as race, religion, color, national origin, sex, sexual orientation, gender identity, genetic information, pregnancy or age. Sully.ai prohibits any form of workplace harassment._ 

🚀 Y Combinator Company Info

Y Combinator Batch: S21
Team Size: 49 employees
Industry: B2B Software and Services -> Productivity
Company Description: AutonomousOS for healthcare organizations

💰 Compensation

Salary Range: $230,000 - $260,000

📋 Job Details

Job Type: Full-time
Experience Level: 6+ years
Engineering Type: Backend