---
title: 'Principal Software Engineer at Foundation Health'
canonical: 'https://feeny.ai/job/principal-software-engineer-foundation-health-orlando-5t23nwvgf9y1'
type: 'job'
last_seen: '2026-09-07'
---

# Principal Software Engineer at Foundation Health

- **Company:** Foundation Health
- **Location:** Orlando, FL
- **Employment:** full-time
- **Posted:** 2026-08-12
- **Last confirmed live:** 2026-09-07
- **Apply:** https://jobs.ashbyhq.com/foundationhealthcareers/2860d5cb-3b1c-4612-ad17-dd9b3c9422f6

## Job description

## About Foundation Health

Foundation Health is an AI operating system for pharmacy - built by a team who lived the problem firsthand, not one that came to healthcare from the outside. Every day, prior authorizations delay prescriptions, pharmacists lose hours to paperwork instead of patients, and prescriptions slip through the cracks between health systems. We believe thoughtfully applied AI can finally change that - deep, integrated infrastructure that streamlines how care is coordinated, purpose-built for the complexity of specialty pharmacy.

We're building toward a world where pharmacy teams spend their time on patients, not paperwork - where AI handles the routine so clinicians can focus on what only humans can do. Getting there takes the right people. We're looking for curious, ambitious folks who want to help solve healthcare's hardest problems - for our patients, our partners, and each other.

## The Role

You'll be the technical anchor for our brand new engineering hub in Orlando, working directly alongside our VP of Engineering (ex-DeepMind/Google) and a 2x Founder CEO.

Owning architecture across multiple product areas. Setting the standards everyone else builds to. Making the calls that decide where this platform is in two years, not just this quarter.

One thing we're clear on: this isn't an ivory-tower architect role. You'll lead system design and get into the codebase when it matters. At Foundation Health, technical credibility comes from doing, not directing.

And you're doing it on a greenfield codebase. No decade of technical debt, no committee sign-offs, no waiting three sprints for someone to approve a migration. Hard, interesting problems — and the autonomy to solve them properly.

What you'll actually do:

Own platform architecture. Design systems that handle 10-100x growth without a rewrite. Establish the patterns the wider engineering org adopts. Spot the root-cause problems before they get expensive.

Define how we use AI — everywhere. Not just in the product (voice agents, clinical workflows), but in how the engineering org itself works. You'll own model selection, latency and cost tradeoffs, evaluation methodology, and the quality and safety bar for everything AI-related that ships.

Shape the roadmap, not just execute it. Work directly with product leadership. Push back where it's needed. Separate what's high-leverage from what's noise. Drive cross-team initiatives where success means product outcomes, not ticket throughput.

Grow the engineers around you. Help build the next generation of technical leaders in the hub — by example first, mentorship second.

Who we're looking for

- You've built complex systems from scratch — and you can still get into the code, not just review it
- Strong engineering judgment: you know when to move fast and when to slow down, and you frame technical decisions in business terms
- Genuine AI fluency — you've shipped AI-powered products, and AI tooling is a natural part of how you work, not a box you tick
- High agency: you don't wait for a perfectly scoped ticket, you figure out what needs to happen and do it
- US-based, or willing to relocate to Orlando

The Setup:

- Everything you ship touches real patient care in real health systems.
- We're past product-market fit. Enterprise health systems are live on the platform and asking for more — the "will anyone buy this" question is answered. Now we build.
- The influence here is real — on the architecture, the culture, and the direction of the entire engineering org. We've done the hard part of proving people want this. Now we build.
- Significant equity comes with the role. So does a seat at the table from day one.

## About Foundation Health

## Company Overview
- **One-liner**: Foundation Health provides an AI-powered operating system for pharmacy and digital healthcare, automating workflows for prior authorization, refills, and patient communication.
- **Entity Type**: Private (Series A)
- **Headquarters**: Menlo Park, California, United States
- **Founded**: 2023
- **Founders**: Umar Afridi (CEO & Founder)

## Core Business
- **Primary industry**: Healthcare technology / Digital pharmacy / Prior authorization automation
- **Target customers**: Health systems, health plans/insurers, pharmaceutical manufacturers, consumer health companies (B2B, enterprise)
- **Mission / purpose**: “Delivering the future of digital healthcare” – modernizing healthcare by reducing administrative friction so clinicians can focus on patient care.

## Products & Services
- **PAIGE (AI Operating System for Pharmacy)**: An AI assistant that automates repetitive pharmacy tasks such as prior authorization, refill authorization, 340B compliance audits, and patient communication. Includes workflow orchestration, task tracking, and exception management.
- **Digital Front Door**: White-labeled patient-facing interface for managing specialty and retail prescriptions, auto-refills, prescription transfers, copay payments, and delivery tracking.
- **Prior Authorization Automation**: End-to-end automation including benefits investigation, eligibility checks, test claims, generation of draft responses to payer questions, and auto-generated appeal letters for denials.
- **Refill Authorization**: Accelerates refill workflows under Collaborative Practice Agreements with AI pre-screening and pharmacist oversight.
- **340B Optimization**: Automates compliance audits by integrating TPA and EHR data to maximize eligible capture and recapture revenue.
- **Financial Assistance**: Identifies eligible patients for manufacturer copay coupons, quick start programs, and patient assistance foundations, then automates enrollment workflows.
- **MSOT Queue Automation**: Integrates with EPIC MSOT queue to automate manual workflows and expedite specialty prescription routing.
- **Patient Communication (SMS & VoiceAI)**: Automated outreach for patient assessments, adherence, and delivery coordination, with responses routed back into pharmacy workflows.
- **Pharmacy API**: Developer-first API for integrating telehealth, pharmacy, and diagnostics, handling compliance, logistics, and provider networks.

## Market Standing
- **Valuation**: Not publicly available (last funding round was Series A)
- **Key Metric**: Total raised $26M (Series A of $20M raised approximately 8 months ago as of mid-2025)
- **Notable Investors/Partners**: Not publicly disclosed; the company emphasizes its team’s experience (built the first Pharmacy API and operated nationwide pharmacies, physician clinics, and diagnostic centers across the US and Europe)
- **Growth Signals**: Founded in 2023, raised $26M in Series A; serving over 100 brands, shipping 20M+ prescriptions, serving 2M+ patients; mentions partnerships with leading health systems (e.g., Intermountain Health)

## Competitive Advantages
- **AI‑first platform purpose‑built for pharmacy workflows** – reduces prior authorization time by 50%, increases refill authorization throughput 2× per FTE.
- **Compliance built‑in** – HIPAA compliant and SOC 2 Type 2 certified, reducing risk for enterprise customers.
- **Full‑stack healthcare experience** – team has built and operated digital pharmacies, telehealth, and diagnostic services for Fortune 500 companies, plus physical pharmacies and clinics in the US and Europe.
- **Developer‑friendly API** – first‑in‑kind Pharmacy API that allows partners to ship compliant healthcare experiences quickly.
- **White‑label digital front door** – preserves health system brand while centralizing prescription management for patients.

## Strategic Focus
- Expand the AI operating system to cover additional pharmacy and payer workflows (denials, appeals, adherence).
- Deepen integrations with major EHRs (EPIC) and pharmacy management systems.
- Grow partnerships with health systems, health plans, and pharmaceutical manufacturers to drive adoption of the platform.
- Continue scaling the Developer API to enable third‑party innovation in digital pharmacy.

## Why Work Here
- **Remote‑first culture** – “Work from anywhere and thrive in a flexible, digital‑first environment.”
- **Generous PTO** and flexible working hours.
- **Comprehensive health, dental, and vision** coverage.
- **Employee stock option program** – invest in growth and share in the company’s success.
- **Meaningful impact** – directly reduce administrative burden for pharmacists and improve patient access to therapy.
- **Engineering culture** – the team built the first Pharmacy API; developers work on a compliance‑focused, API‑driven platform serving millions of patients.

## Sources
1. [foundationhealth.com](https://www.foundationhealth.com/)
2. [foundationhealth.com/about](https://www.foundationhealth.com/about)
3. [foundationhealth.com/careers](https://www.foundationhealth.com/careers)
4. [jobs.ashbyhq.com](https://jobs.ashbyhq.com/foundationhealthcareers)
5. [cbinsights.com](https://www.cbinsights.com/company/foundation-health)

## Other roles at Foundation Health

- [Software Engineer](https://feeny.ai/job/software-engineer-foundation-health-orlando-1d38wq05td3s) — Orlando, FL
- [Senior Software Engineer](https://feeny.ai/job/senior-software-engineer-foundation-health-orlando-1z1ev2jh82n7) — Orlando, FL
- [Staff Software Engineer](https://feeny.ai/job/staff-software-engineer-foundation-health-orlando-bc1x0k6m7zcm) — Orlando, FL
- [Principal Software Engineer](https://feeny.ai/job/principal-software-engineer-foundation-health-orlando-j4ah42hjhjhf) — Orlando, FL
- [BizOps Manager](https://feeny.ai/job/bizops-manager-foundation-health-manchester-y9aga8484100) — Manchester
- [Pharmacy Operations Specialist (PharmD)](https://feeny.ai/job/pharmacy-operations-specialist-pharmd-foundation-health-united-states-yf1mwr2b621t) — United States
- [QA Lead](https://feeny.ai/job/qa-lead-foundation-health-united-kingdom-6kv3x4kpgvej) — United Kingdom
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- [Product Manager](https://feeny.ai/job/product-manager-foundation-health-united-states-rmyzekh1fhhv) — United States
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