FoundingAI-NativeEngineer

Rockstar is recruiting for an **AI-native operations platform for patient access** — the behind-the-scenes work of getting patients enrolled in assistance programs, verifying coverage, and moving cases through review. Their thesis is simple: **AI handles the routine, humans handle the judgment calls.** They're in build mode for their first deployment, a patient access infrastructure company serving emerging biopharma, with **go-live targeted later in 2026.** They're hiring **one or two senior engineers** to build this platform with them. Given the size of the team, **each hire carries the weight of a founding engineer** — you will own entire verticals of the product, make architectural calls that we live with for years, and ship code that real patient cases flow through starting this fall. They are looking for engineers who **build with LLMs the way previous generations built with databases** — as a first-class architectural primitive, not a bolt-on. ### What you'll own You won't be handed tickets. **You'll own problem spaces end-to-end.** That looks like: * **Designing and shipping the AI agents that run patient case lifecycle** — application intake, document extraction, data validation, coverage verification, patient communication, missing-info follow-up — including the evaluation harness, confidence thresholds, and human-in-the-loop boundaries * **PHI-aware data architecture:** de-identification pipeline that strips identifiers before inference, the tokenization layer that maps results back, and the audit trail that logs every model call * **Integrations with healthcare systems of record** and dependent services – as well as the orchestration layer that coordinates across them * **The production bar:** on-call, incident response, rollback strategy, and strict uptime SLAs * **Working directly with operations, IT, and clinical teams** during discovery, UAT, and go-live — you'll be in the room, not behind a PM ### What they are looking for * **5+ years shipping prod