Clara is building the first AI-first medical practice from the ground up. We're reimagining primary care and providing patients with deep insights and immediate diagnosis and treatment in ways not previously possible.
Clara's founders have built and scaled a previous telemedicine company to over $100m in revenue and we're funded by top investors.
This is a mission-driven, high-performance team at the forefront of healthcare and AI, working in person in San Francisco 5 days per week. We will assist with relocation and work visas for the right candidate.
What you'll build
You'll own Clara's AI brain - the LLM-powered system that enables immediate diagnosis and treatment. This isn't chatbot work; it's medical AI that needs to be accurate, safe, and cost-effective at scale.
Your responsibilities
LLM integration & optimization (50%):
Build and optimize LLM integration for medical insights, diagnosis and treatment
Implement streaming chat responses with proper error handling
Manage context windows for complex medical conversations
Optimize prompt engineering for clinical accuracy and safety
Control LLM costs through model selection, caching, and prompt efficiency
AI infrastructure (30%):
Build semantic search and RAG systems
Implement vector similarity search for medical record retrieval
Design memory systems for patient conversation context
Build evaluation framework for groundedness, safety, and correctness
Medical AI safety (20%):
Ensure AI responses are medically grounded (no hallucinations)
Implement guardrails for high-risk medical scenarios
Monitor and improve AI quality metrics
Token management and cost monitoring
What we're looking for
Required:
3+ years software engineering, including 12+ months shipping LLM applications to production
Strong prompt engineering skills with measurable results
Experience with RAG systems and semantic search
Python for AI/ML workflows
Understanding of token economics and cost optimization
Care about AI safety in high-stakes domains
Ideal:
Medical domain knowledge or healthcare AI experience
Experience with embedding models
Built evaluation frameworks for LLM quality
Vector databases and semantic search systems
Memory systems for multi-turn conversations
What Clara offers founding engineers
Impact:
Ship code that affects real patient health outcomes
Make architectural decisions for an AI-first medical practice
Work directly with CTO on technical strategy
Team & culture:
High-performance founding team at the forefront of healthcare AI
In-person collaboration in San Francisco (5 days/week)
Talk to real patients and providers regularly
No bureaucracy, ship fast
Compensation:
Competitive SF salary ranges
Meaningful founding team equity
Health insurance and standard benefits
Growth:
First engineering hires → opportunity to become engineering managers as team scales
Ownership of entire domains (data, AI, product, platform)
Work with cutting-edge AI and healthcare technology