--- title: 'Lead Infrastructure Engineer at Onos Health' canonical: 'https://feeny.ai/job/lead-infrastructure-engineer-onos-health-san-francisco-jxg5ygp4htr6' type: 'job' last_seen: '2026-09-07' --- # Lead Infrastructure Engineer at Onos Health - **Company:** Onos Health - **Location:** San Francisco, CA - **Employment:** full-time - **Work type:** hybrid - **Posted:** 2026-08-26 - **Last confirmed live:** 2026-09-07 - **Apply:** https://jobs.ashbyhq.com/onoshealth/cdebee3f-b0b8-4816-8d9b-649199bb1dfa ## Job description ## ABOUT ONOS HEALTH Onos Health’s mission is simple but ambitious: ensure every healthcare dollar goes toward delivering the highest quality care. Today, 30% of total U.S. healthcare spending is wasted due to ineffective care and administrative burden caused by misalignment between providers and payers. Onos is addressing this by building the largest AI-driven healthcare data platform. Our models enables payers to make faster, more accurate decisions across their populations. By guiding members to the right care, Onos is channeling more dollars to high-quality care that drives better outcomes while making healthcare more affordable. Onos is well-funded by some of the best healthcare investors and is working with the nation’s largest health plans. Come join a category-defining company and help reimagine healthcare for the better. WHY ONOS? - Meaningful impact: Help fix what is fundamentally broken in healthcare - Direct collaboration: Work alongside experienced founders with deep healthcare and data expertise - Culture: Join a high-performing, transparent, and results-oriented team - Ownership: Significant responsibility and autonomy from day one - Opportunity: Play a pivotal role in building a fast-growing, category-defining healthcare AI company ## THE ROLE We're seeking an experienced infrastructure engineer to become our first dedicated platform hire and the owner of the infrastructure the Onos platform runs on. Onos is in production with the nation's largest health plans, which comes with contractual uptime SLAs, disaster recovery commitments, and a security bar (SOC 2, HIPAA) our clients audit. Until now this has been carried collectively by our product engineers and founders — you'll own it end to end. We build heavily with AI coding agents, so much of your leverage will come from specifying work well and directing agents rather than typing every line yourself; prior tech lead or engineering management experience translates directly. As an early team member, you'll set the patterns every future platform engineer at Onos inherits. This role is a hybrid role based in San Francisco, where you'll be expected to work at our office in person 3 times a week. WHAT YOU'LL BE DOING AT ONOS: - Own our availability, disaster recovery, and backup commitments to enterprise clients — multi-region failover architecture and the recovery exercises that prove it - Stand up production monitoring, alerting, SLOs, and our on-call rotation and incident response process - Own the technical controls behind SOC 2 and HIPAA: cloud security posture (AWS org guardrails, IAM least-privilege, KMS/encryption), vulnerability remediation, and continuous audit evidence through Vanta, with a path toward HITRUST - Build the CI/CD pipelines, Terraform/IaC foundations, preview environments, and test infrastructure the whole team ships on - Build the guardrails that let AI coding agents ship safely — policy-as-code, deploy verification, and agent-operated operations tooling - Set the strategy and operating rhythm for platform work: priorities, status, and what we deliberately defer ## TECHNICAL CHALLENGES AT ONOS: - Architect AI SRE agents to ensure up-to-date compliance and reliability, enabling engineers to work more effectively and strategically - Right-size enterprise-grade reliability: SLOs and alerting you can trust without drowning a small team in pager noise - Turn compliance into continuously verified infrastructure — security controls and audit evidence as code - Scale a CI/CD and environments platform where AI agents, not just humans, are the primary users - Support multi-region disaster recovery with defined RTO/RPO targets and immutable, restore-tested backups for a multi-tenant healthcare platform ## TECH STACK: At Onos, we work with a modern tech stack where we continuously evaluate and adopt cutting-edge technologies as we scale. - Infrastructure/Systems: AWS (ECS, Bedrock, Glue, etc.), Langfuse, Terraform - Languages/Frameworks - Backend: Python, Django, Celery / Celery Beat, django-ninja, django-tenants - Frontend: NextJS, Typescript, Tanstack Query, Shadcn UI, Zod, Nuqs - Database/Storage: PostgreSQL (AWS RDS), S3, Clickhouse - Development Tools: Github, Linear, Claude Code, Codex, CoderabbitAI ## WHAT WE'RE LOOKING FOR: - Deep AWS experience — you've owned production cloud infrastructure end to end (IAM, networking, KMS, containers, managed databases) - Strong Terraform/IaC and CI/CD expertise; you treat pipelines and environments as products with users - Taken a company through at least one SOC 2 (or HITRUST/ISO 27001) audit cycle with your hands on the technical controls - SRE fundamentals — SLOs, incident management, DR design — with the judgment to right-size reliability for a startup with enterprise contracts - Prior experience leading engineering teams as a tech lead or engineering manager — you can break down ambiguous goals, delegate (to humans or AI agents), and communicate crisply with non-technical stakeholders - Customer obsessed and motivated to make an impact in the healthcare space ## BONUS POINTS IF YOU HAVE: - Significant experience in healthcare or another regulated industry, with HIPAA fluency - Policy-as-code (OPA, Kyverno) or compliance automation (e.g., Vanta, Drata) experience - Been the first infrastructure hire, or helped found or lead a platform team - Built internal tooling or infrastructure for LLM/agent systems ## BENEFITS AND PERKS - Hybrid arrangement: 3 days/week at San Francisco office (Financial District) - Unlimited vacation policy - Paid parental leave - Medical, dental, and vision insurance - Pre-tax commuter benefits - 401(k) - Significant equity as an early employee - Direct mentorship from experienced founders - Ground-floor opportunity to help build a team and culture - Regular team events and offsites - Company-provided equipment and home office setup We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. ## About Onos Health ## Company Overview - **One-liner**: Onos Health provides an AI-powered platform that helps health plans reduce waste and improve quality in behavioral health programs. - **Entity Type**: Private (Seed stage; raised $6.3M in June 2025) - **Headquarters**: San Francisco, California, United States - **Founded**: Not publicly available - **Founders**: Akshay Agrawal (CEO) and Suhaas Prasad (CTO) ## Core Business - **Primary industry**: Healthcare IT – specifically behavioral health technology for payers - **Target customers**: Health plans (payers) that manage behavioral health benefits, including government-sponsored programs - **Mission statement**: “Fix what’s broken in behavioral health” – the company aims to streamline operations, reduce loss, and ensure higher-quality care. ## Products & Services - **Onos Platform (AI-Powered Behavioral Health Management)**: A SaaS platform that combines machine learning, large language models, and generative AI to: - Alert health plans when members deviate from appropriate care paths and recommend corrective actions. - Detect fraud, waste, and abuse early. - Provide a 360-degree view of each member’s condition and care. - Unify clinical review, utilization management, and provider quality assessment in a single, collaborative web application. - Support full spectrum of behavioral health diagnoses and all care settings (outpatient, intensive outpatient, inpatient, crisis stabilization, school-based, etc.). - **Integration Options**: Supports flatfile/CSV, API connections to claims/RCM/EMR systems, or direct data warehouse/lake integration. - **Configuration**: Can be tailored to a health plan’s data, service lines, and clinical guidelines. ## Market Standing - **Valuation/Market Cap**: Not disclosed - **Key Metric**: Total funding raised – $6.3M (Seed round, June 2025) - **Notable Investors/Partners**: Seed round led by **Haystack** and **Pathlight Ventures**; 4 investors total. - **Growth Signals**: - 17 employees as of mid-2025, with active hiring for 6+ open roles (Staff Engineers, AI/ML, Product, Marketing). - Job postings increased 50% month-over-month. - LinkedIn follower count: 885. - Company featured in Axios coverage of the fundraise (October 2025). ## Competitive Advantages - **Behavioral-health-specific AI models**: Proprietary models trained exclusively on millions of claims, clinical notes, plan policies, and member data points – not general-purpose AI. - **HIPAA compliance**: Built by security professionals with payer experience; uses locally hosted AI/ML models to protect PHI. - **Reinforcement Learning with Human Feedback (RLHF)**: The platform continuously improves by incorporating team decisions back into the model. - **End-to-end unification**: Brings together scattered clinical data and cross-functional teams (clinical review, utilization management, provider collaboration) in one platform. ## Strategic Focus - **Reduce waste in behavioral health**: Onos targets the estimated 30% of every behavioral health dollar that goes to waste, aiming to cut that significantly. - **Improve clinical oversight and provider quality**: Real-time alerts and recommendations keep members on effective care paths. - **Expand data integration and configurability**: The platform works with existing payer systems and can be customized for each client’s policies and preferences. ## Why Work Here - **Mission-driven**: Employees focus on transforming a broken part of healthcare with measurable impact. - **Small, collaborative team**: Currently 17 people, offering high ownership and direct influence. - **Hybrid work policy**: Open positions list San Francisco as location, with hybrid expectation. - **Engineering culture**: Teams use modern tech stack (Python, Django, React, TypeScript, PostgreSQL, ClickHouse, PyTorch, Docker, Terraform, GitHub Actions, MLOps) and are building cutting-edge AI for healthcare. - **Open roles**: Staff Software Engineer (Full Stack & AI/ML), Lead Engineer (Backend & Data/Integrations), Forward-Deployed Product Manager, Senior Software Engineer, Head of Marketing. ## Sources 1. [onoshealth.com](https://onoshealth.com/) 2. [onoshealth.com/about-us](https://onoshealth.com/about-us/) 3. [onoshealth.com/career](https://onoshealth.com/career/) 4. [linkedin.com/company/onos-health](https://www.linkedin.com/company/onos-health) 5. 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