Senior AI Engineer

Sixty million Medicare seniors live with chronic disease. The care system sees most of them twice a year. Cadence is building the infrastructure to support them every day.

Cadence is a clinical AI company that delivers continuous, proactive care for older adults with chronic conditions like hypertension, heart failure, and diabetes. We pair patients with a dedicated clinical team, integrate deeply into health system EMRs and workflows, and use our Clinical Intelligence platform to monitor vitals, surface risk early, optimize medications, and close care gaps between visits. The result: patients engage with care 100x more than before Cadence, clinicians focus on judgment instead of administrative work, and Medicare saves $2M a week.

We operate as a full clinical care delivery organization, not a software vendor. Our clinicians work alongside health system partners, extending the reach of local primary care providers into patients' homes. We're now applying AI agents across these workflows – from alert review and medication titration to lifestyle coaching and care coordination – with clinicians always in control of clinical decisions.

The Role
We're hiring a Senior AI Engineer to design and ship production agents that synthesize real-time clinical data, surface proactive care recommendations, and take action on behalf of clinicians.

You will take agent architectures from prototype to production in a domain where reliability directly affects patient outcomes. You'll own the full lifecycle of AI-powered clinical workflows: retrieval, reasoning, tool use, evaluation, and safety guardrails. If you've built agentic systems at scale and want your work to matter beyond engagement metrics, we’d love to speak with you.

What You'll Do

• Design, build, and deploy clinical AI agents that reason over patient context, invoke tools, and generate care recommendations.
• Own reliability, observability, and cost efficiency of LLM-powered workflows at scale.
• Build and optimize RAG pipelines over clinical knowledge bases, treatment protocols, and real-time patient data.
• Develop evaluation frameworks: offline benchmarks, safety tests, regression suites, and LLM-as-judge pipelines wired into CI/CD.
• Design multi-step agent orchestration: planning, memory, tool use, error recovery, and human-in-the-loop escalation paths.
• Collaborate with clinical, product, and engineering teams to translate patient care needs into AI system design.
• Stay at the forefront of AI and engineering best practices, continuously pushing the team to raise the bar on quality, performance, and architecture.

What You Need

• Bachelor's or Master’s degree in Computer Science, Engineering or related field, or equivalent work experience
• 5+ years of software engineering experience, with 2+ years building AI/ML-powered systems in production
• Experience in a high-growth, fast-paced environment with end-to-end ownership from design through production
• Hands-on experience with LLM APIs (OpenAI, Anthropic, open-source models) including prompt engineering, tool use / function calling, and structured outputs
• Experience building RAG systems: embeddings, vector stores, retrieval optimization, and grounding
• Experience with agent frameworks or orchestration patterns (tool calling, planners, multi-agent coordination) preferred
• Fine-tuning experience (SFT, RLHF, LoRA) on domain-specific tasks preferred
• Healthcare or regulated-industry experience (HIPAA, SOC 2, clinical data handling) preferred

Compensation
Our job titles may span more than one career level. The base salary for this role typically ranges between $180,000 – $245,000 annual base salary, depending on experience, skills, seniority, and business needs. In addition to base salary, this role is eligible for equity as part of the total compensation package. Actual compensation may vary by location.

Benefits & Perks

• Competitive pay & equity*
• Fully remote
• Comprehensive health coverage: Medical, dental & vision
• Paid time off
• 401k plan + matching
• Paid parental leave
• Home office stipend
• benefit offerings may vary depending on job profile, job level and worker type

_Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws.

__A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team. Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.

_If you require a reasonable accommodation during the interview or hiring process, please notify your recruiter.