We’re rebuilding psychiatry from the ground up—AI-native, insurance-covered, and engineered to scale.

Legion Health is a high-quality psychiatry network where patients get care from licensed clinicians, fast and affordably. Under the hood, our LLM agents and orchestration layer automate operations, reduce admin, and enable truly great care.

Most startups bolt AI onto broken workflows. We’re replacing the workflows—and the system underneath.

If you’ve ever wanted to use AI to actually fix something that matters, this is your shot.

Build AI-native care infrastructure. Ship into real patient care. Operate at speed.

Hey—I’m Daniel, co-founder & CTO of Legion Health (YC S21). We’re building the AI-native operations layer for psychiatric care: scheduling, intake, documentation, billing, risk detection, and coordination. Not “doctor-in-a-box”—the operational backend that mental health actually runs on.

We run our own psychiatric practice. The systems you build ship directly into real clinical workflows. Our agent infrastructure already supports 2,000+ patients with one human, and we’re hiring a Founding Engineer to own core backend + agent systems end-to-end.

You’ll architect our event-driven backend (Node.js / TypeScript / Supabase / AWS), build real LLM agents with tool use + memory + retries, shape internal operations UX that both humans and agents co-use, and ship product end-to-end. You don’t need to come in as a pure backend engineer—we’re open to strong product/full-stack engineers who think in systems and are excited to deepen their backend + AI infrastructure skills.

This role is in-person in San Francisco. Roles evolve fast here—including mine. I’m looking for someone who wants to grow into owning major parts of the system, not someone relying on me staying in a narrow CTO role forever.

🚀 If you’ve built complex systems or shipped product end-to-end with real ownership, think in events/state/flows, and want to deepen your backend + AI systems skills—we should talk.

Technology at Legion

We are revolutionizing telepsychiatry through a core AI infrastructure that enables a vastly improved patient experience and quality of mental health care. We are actively improving our services in ingesting, chunking, embedding, caching, and searching to achieve this goal. Our technical goals include:

• Enhanced processing: Implement robust data structures and caching mechanisms to handle increasing volumes of language data spanning every facet of patients’ care while minimizing latency and maximizing system responsiveness.
• System scalability: Ensure our systems can scale effectively to support growth from one million to hundreds of millions of data points.
• Securing sensitive data: Uphold the highest standards of data security and privacy in compliance with HIPAA guidelines.

##Stack TypeScript, Node.js, PostgreSQL, Redis, Supabase, Azure, Google Cloud, AWS, LangChain, PostHog, Retool