Midstream is an AI-native financial operating system for health systems, founded by experienced entrepreneurs and backed by top-tier investors. We give finance, supply chain, and managed care teams real-time visibility into where margin is at risk, with a precise action plan for capturing it before it's gone.

Purpose-built for healthcare's complexity, Midstream transforms structured, unstructured, and external data into instant, contract-aware insights that drive smarter decisions. Our AI agents unify spend and revenue operations across the full back-office, learning and adapting with every interaction and delivering always-on intelligence that no point solution or one-off engagement can match.

We're compressing months to minutes and turning post-period hindsight into in-the-moment foresight. The tempo of healthcare finance is changing, and Midstream is leading it.

Opportunity

As a Member of Technical Staff, you’ll build AI-native products that solve complex, high-impact problems for some of the country’s largest health systems.

Your work will span wherever you can create the most value. You might spend a week at a customer site rapidly building and testing a prototype, then turn those learnings into a scalable platform capability back at HQ. At other times, you may go deep on our data infrastructure, agentic workflows, ML platform, or core product experience.

We’re looking for engineers with strong technical craft who are motivated by the mission, not the boundaries of a particular domain. You’re excited to go wherever the most important problem takes you—and use AI and software to meaningfully change how healthcare operates.

How you'll make an impact

You’ll take ownership of critical capabilities across the Midstream platform, moving fluidly between foundational platform investments and rapidly building solutions to real customer problems. Your work may include some or all of the following:

• SaaS Platform & Infrastructure: Develop key components of our multi-tenant SaaS platform, including Identity & Access Management, connector provisioning, and infrastructure improvements that increase the speed, reliability, and scalability of our products.

• API Development: Design and implement APIs and data models that can support complex healthcare workflows, shared platform capabilities, and customer-specific needs without sacrificing scalability.

• ML Platform Development: Leverage foundational models and develop novel ML solutions to solve problems across complex, high-dimensional healthcare data.

• Agentic Workflows: Build tools and agents that transform how healthcare operators work, including natural-language analytics and workflows that enable rapid discovery of insights with source-level traceability.

• UI Development: Build intuitive product experiences that turn complex datasets and AI-generated insights into clear, actionable workflows for health system users.

• Security & Compliance: Build security into the foundation of our platform, including encryption, role-based access controls, and infrastructure designed to meet standards such as SOC 2 and HIPAA.

• Set Standards and Deliver Impact: As a member of our early engineering team, you’ll work closely with our founders, Product, and customers to identify the highest-impact problems and solve them. Sometimes that means investing deeply in our platform; other times it means getting close to a customer, building quickly, and learning from real-world use. You’ll help set the technical and cultural standards for how we build as the company grows.

Your impact won’t be defined by a particular layer of the stack. It will be defined by the problems you solve, what you learn from customers, and your ability to turn those learnings into technology that can create value across health systems.

Who you are

• Problem-Solving: You’re energized by hard, ambiguous problems and have the technical judgment to break them down, learn quickly, and find a path forward—even when the answer isn’t obvious.

• Communication: You’re a strong communicator who can collaborate across Engineering, Product, and our health system partners. You can explain technical concepts clearly and are comfortable getting close to users to understand the problems you're solving.

• Adaptability: You thrive in fast-moving environments and are comfortable following the most important problem. You can move from building a customer prototype to strengthening a core platform capability without viewing either as outside your job.

• Programming Skills: You have excellent coding abilities in high-level languages such as Python and TypeScript and strong software engineering fundamentals.

• SaaS Platform Development: You have experience building scalable software platforms, including API design, CI/CD, multi-tenancy, and role-based access control.

• Cloud Platforms: You have strong experience with cloud services such as GCP or AWS and infrastructure-as-code technologies such as Kubernetes and Terraform, with the ability to leverage cloud-native services across compute, storage, data, and ML applications.

• Experience: You have a bachelor's degree in Computer Science, Engineering, or a closely related field, or equivalent professional software engineering experience.

Above all, you’re excited by the opportunity to use technology and AI to make a meaningful impact on healthcare. You care about building excellent software, but you care even more about whether what you build solves a real problem. You’re willing to learn a new domain, pick up a new technology, sit alongside a customer, or work outside your usual comfort zone when that’s what it takes to deliver meaningful impact.