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Harness Engineer
Substrate · San Francisco, CA, US
Pay
$140k–200k
Setting
On-site
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Harness Engineer at Substrate(S24)
$140K - $200K • 0.01% - 0.10%
Artificial Intelligence for your medical billing team
San Francisco, CA, US
Full-time
US citizen/visa only
3+ years
Apply now
About Substrate
Substrate is building browser based AI agents for healthcare RCM. Our goal here is to augment and replace employees, not replace any particular software a provider uses. We’ll go after the $14b outpatient RCM market, and if we’re successful, providers will finally start getting paid fairly.
We’re the right team for this problem with deep healthcare, AI & fullstack engineering expertise, multiple startups under our belt between us, and a deep network in healthcare that will help bootstrap the first customers and real revenue.
About the role
About Substrate
Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. We’re focused on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate AR, and get reimbursed quickly and cost effectively. We already touch over 500k healthcare claims each month.
The Role
We're looking for an exceptional Harness Engineer to help build the systems around our agents and AI products. You'll be instrumental in advancing AI systems that are already in production, and improving success rates for probabilistic products, and precision for deterministic ones. You’ll build systems that can understand complex healthcare contracts, read EDI companion guides, utilize tools for navigating highly sensitive healthcare infrastructure and banking/financial infrastructure, and make intelligent decisions about claims processing - all in service of helping healthcare providers get paid fairly.
What You'll Work On
Build and extend our suite of agents - Design agents and the systems around them to do a variety of tasks for healthcare practices, including monitoring claims, reviewing payer policies, determine medical necessity, iterate through messy provider data, reconcile payments, and more.
Deploy agents and the systems around them - Partner with clients and prospects on frontier use cases, getting agents to work safely in extremely sensitive environments.
Develop high quality measurement infrastructure: improve how we measure and track agent and model behavior, increase precision, and build systems to help optimize speed, and cost on production traffic touching tens of millions of claims each year.
Adapt with the nature of work: How work gets done is changing. Individuals have enormously more leverage than ever before. A big part of the role (and all roles at Substrate) is exploring how to be more effective, efficient and leveraged as the toolscape evolves rapidly around us.
You Might Be a Fit If
You’ve been load bearing in previous roles, and are willing to take an extreme amount of ownership.
You are interested in going deeper into problems than anyone reasonable would, in service of excellence.
You have a track record of independently building and shipping ML/AI products that solve real business problems
Deep experience with modern LLM architectures, fine-tuning approaches, and utilizing evals at scale
You either have healthcare domain knowledge already, or you’re excited about using AI to automate the tedium in healthcare
You’ve either started a company before, launched and scaled independent products, or have been an early startup engineer
You are both proficient as a software engineer in the traditional sense, and you've fully adopted coding agents into your workflow.
You’re excited about working in person, in San Francisco, 3 days a week.
Some general color on what we’re looking for: https://writing.kunle.app/p/come-work-with-me-at-substrate .
We encourage you to apply even if you do not believe you meet every single qualification. Not all strong candidates will meet every single qualification as listed. If you spike extremely in certain areas or not in others, or if you’re extremely interested in this work and willing to go very deep to create something special, please apply and lets chat.
Compensation
Meaningful salary and equity available.
Interview Process
We want you to show us something you've built. It can be completely by hand or it can be completely AI-generated, but we want you to explain exactly how it was built, show us what prompts you used, and in particular why you picked this problem to solve, and show us the results.
Your technical interview will feature both a pure technical part that evaluates your coding abilities and your ability to write and review code, and an AI-assisted part that shows how you are adopting AI technologies in your coding practice and what benefits you've gotten from them.
Apply now
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Listed by Substrate for a position based in the United States. Employers on this board attest they are hiring domestically.
Forward Deployed Engineer (Senior)
Substrate · San Francisco, CA, US
Pay
$125k–200k
Setting
On-site
Work at a Startup
Startup Jobs
Resume Review
Education
How it Works
Log In
Forward Deployed Engineer (Senior) at Substrate(S24)
$125K - $200K • 0.01% - 0.10%
Artificial Intelligence for your medical billing team
San Francisco, CA, US
Full-time
US citizen/visa only
3+ years
Apply now
About Substrate
Substrate is building browser based AI agents for healthcare RCM. Our goal here is to augment and replace employees, not replace any particular software a provider uses. We’ll go after the $14b outpatient RCM market, and if we’re successful, providers will finally start getting paid fairly.
We’re the right team for this problem with deep healthcare, AI & fullstack engineering expertise, multiple startups under our belt between us, and a deep network in healthcare that will help bootstrap the first customers and real revenue.
About the role
About Substrate
Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. We’re focused on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate AR, and get reimbursed quickly and cost effectively. We already touch over 6m claims/yr.
The Role
We're looking for an exceptional Forward Deployed Engineer to help large healthcare organizations safely and productively deploy AI within mission critical RCM workflows including AR Follow up, Payment Reconciliation, Lockbox Automation, Collections Management, Appeals management, and more. You'll be instrumental in ensuring high quality deployments are delivered on time, measured well, coordinated with change management, and continuously optimized and improved as we scale.
What You'll Work On
Problem Definition & Solution Design: deeply understanding A client's needs and articulating them in a way that our team can clearly understand and rethinking clients' workflows from first principles in an AI-native way.
Productize Onboarding & Implementation: Create onboarding and implementation workflows and playbooks that enable us to onboard many, many more enterprise-scale clients in parallel at once with a results orientation.
Manage Deployments and Support Operations: scalably deploy agents in mission critical environments with extremely sensitive data, alongside a small dedicated team.
Build Trust: Act as a trusted advisor to healthcare organizations navigating the rapidly changing AI landscape.
You Might Be a Fit If
You have a track record of independently building and shipping ML/AI products that solve real business problems
Deep experience with modern LLM architectures, fine-tuning approaches, and utilizing evals at scale
You either have healthcare domain knowledge already, or you’re excited about using AI to automate the tedium in healthcare
Excellent communication skills and experience working directly with enterprise customers, in a front facing role
Ability lead cross-functional engineering efforts and deliver production systems
You’re excited about working in person, in San Francisco.
Some general color on what we’re looking for: https://writing.kunle.app/p/come-work-with-me-at-substrate .
We encourage you to apply even if you do not believe you meet every single qualification. Not all strong candidates meet every single qualification. If you’re experiencing imposter syndrome and doubting the strength of your candidacy, please don’t exclude yourself prematurely. Slope often matters far more than intercept. If you spike extremely in certain areas or not in others, or if you’re extremely interested in this work and willing to go very deep to create something special, please apply and lets chat.
Compensation
Meaningful salary and equity available. We’re building a small, tight knit team whose motivated to win together.
Interview Process
We want you to show us something you've built. It can be completely by hand or it can be completely AI-generated, but we want you to explain exactly how it was built, show us what prompts you used, and in particular why you picked this problem to solve, and show us the results.
Your technical interview will feature both a pure technical part that evaluates your coding abilities and your ability to write and review code, and an AI-assisted part that shows how you are adopting AI technologies in your coding practice and what benefits you've gotten from them.
Apply now
Other jobs at Substrate
Agent Engineer (Senior)
San Francisco, CA, US
Full-Time
$125K - $200K
0.01% - 0.10%
3+ Years
View job
Harness Engineer
San Francisco, CA, US
Full-Time
$140K - $200K
0.01% - 0.10%
3+ Years
View job
Technical Success Manager
San Francisco, CA, US
Full-Time
$100K - $130K
0.01%
3+ Years
View job
Hundreds of YC startups are hiring on Work at a Startup.
Sign up to see more ›
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Product Manager Jobs in Los Angeles
Remote Jobs
Remote Software Engineer Jobs
Remote Design & UI/UX Jobs
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Remote Support Jobs
Remote Operations Jobs
Listed by Substrate for a position based in the United States. Employers on this board attest they are hiring domestically.
Agent Engineer (Senior)
Substrate · San Francisco, CA, US
Pay
$125k–200k
Setting
On-site
Work at a Startup
Startup Jobs
Resume Review
Education
How it Works
Log In
Agent Engineer (Senior) at Substrate(S24)
$125K - $200K • 0.01% - 0.10%
Artificial Intelligence for your medical billing team
San Francisco, CA, US
Full-time
US citizen/visa only
3+ years
Apply now
About Substrate
Substrate is building browser based AI agents for healthcare RCM. Our goal here is to augment and replace employees, not replace any particular software a provider uses. We’ll go after the $14b outpatient RCM market, and if we’re successful, providers will finally start getting paid fairly.
We’re the right team for this problem with deep healthcare, AI & fullstack engineering expertise, multiple startups under our belt between us, and a deep network in healthcare that will help bootstrap the first customers and real revenue.
About the role
About Substrate
Substrate (www.substrate.cc) is building the world’s first AI native BPO, starting with healthcare RCM. We’re focused on helping healthcare enterprises like physician groups, EMR providers, and BPOs accelerate AR, and get reimbursed quickly and cost effectively. We already touch over 500k healthcare claims each month.
The Role
We're looking for an exceptional AI Agent engineer to help build our autonomous agent platform and rebuild legacy healthcare workflows with AI Agents at the center. You'll be instrumental in developing AI systems that are already in production, that can understand complex healthcare contracts, read EDI companion guides, utilize tools for navigating highly sensitive healthcare infrastructure, and make intelligent decisions about claims processing - all while maintaining perfect memory of every interaction.
What You'll Work On
Build and extend the Claim Status Agent - Design intelligent sub-agent architectures that orchestrate multi-route claim lookups (EDI 276/277, payer portals, direct APIs, multiple clearinghouses). You’ll implement recovery strategies that adapt in real-time to payer errors.
Develop self-enriching context systems - Create memory infra that lets our agents remember what works, which parameter combinations return actionable data, and how to route optimally across thousands of payers
Fine-tune models and build evaluation frameworks - improve precision, speed and cost on production traffic processing ~6m claims/year and growing. Design evals that catch regressions before clients do.
Expand the agent's capability surface - Integrate new modalities (voice, direct payer connections) and develop techniques for efficiently processing highly varied context across EDI companion guides, payer contracts, PDFs, images, and API outputs
You Might Be a Fit If
You have a track record of independently building and shipping ML/AI products that solve real business problems
Deep experience with modern LLM architectures, fine-tuning approaches, and utilizing evals at scale
You either have healthcare domain knowledge already, or you’re excited about using AI to automate the tedium in healthcare
You’ve either started a company before, launched and scaled independent products, or have been an early startup engineer in a team smaller than 10 people
You are both proficient as a software engineer in the traditional sense, and you've fully adopted coding agents into your workflow.
You’re excited about working in person, in San Francisco.
Some general color on what we’re looking for: https://writing.kunle.app/p/come-work-with-me-at-substrate .
We encourage you to apply even if you do not believe you meet every single qualification. Not all strong candidates meet every single qualification. If you’re experiencing imposter syndrome and doubting the strength of your candidacy, please don’t exclude yourself prematurely. Slope often matters far more than intercept. If you spike extremely in certain areas or not in others, or if you’re extremely interested in this work and willing to go very deep to create something special, please apply and lets chat.
Compensation
Meaningful salary and equity available.
Interview Process
We want you to show us something you've built. It can be completely by hand or it can be completely AI-generated, but we want you to explain exactly how it was built, show us what prompts you used, and in particular why you picked this problem to solve, and show us the results.
Your technical interview will feature both a pure technical part that evaluates your coding abilities and your ability to write and review code, and an AI-assisted part that shows how you are adopting AI technologies in your coding practice and what benefits you've gotten from them.
Apply now
Other jobs at Substrate
Forward Deployed Engineer (Senior)
San Francisco, CA, US
Full-Time
$125K - $200K
0.01% - 0.10%
3+ Years
View job
Harness Engineer
San Francisco, CA, US
Full-Time
$140K - $200K
0.01% - 0.10%
3+ Years
View job
Technical Success Manager
San Francisco, CA, US
Full-Time
$100K - $130K
0.01%
3+ Years
View job
Hundreds of YC startups are hiring on Work at a Startup.
Sign up to see more ›
Work at a Startup
Jobs
Internships
Events
How it works
Sign in
Y Combinator
About YC
Press
Privacy & Terms
Contact
Jobs by Role
Software Engineer Jobs
Design & UI/UX Jobs
Product Manager Jobs
Sales Jobs
Marketing Jobs
Support Jobs
Operations Jobs
Jobs by Location
Software Engineer Jobs in San Francisco
Product Manager Jobs in San Francisco
Software Engineer Jobs in New York
Product Manager Jobs in New York
Software Engineer Jobs in Los Angeles
Product Manager Jobs in Los Angeles
Remote Jobs
Remote Software Engineer Jobs
Remote Design & UI/UX Jobs
Remote Product Manager Jobs
Remote Sales Jobs
Remote Marketing Jobs
Remote Support Jobs
Remote Operations Jobs
Listed by Substrate for a position based in the United States. Employers on this board attest they are hiring domestically.
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