---
title: 'Principal Software Engineer at Foundation Health'
canonical: 'https://feeny.ai/job/principal-software-engineer-foundation-health-orlando-j4ah42hjhjhf'
type: 'job'
last_seen: '2026-09-07'
---

# Principal Software Engineer at Foundation Health

- **Company:** Foundation Health
- **Location:** Orlando, FL
- **Employment:** full-time
- **Posted:** 2026-08-25
- **Last confirmed live:** 2026-09-07
- **Apply:** https://jobs.ashbyhq.com/foundationhealthcareers/3d0d7d8a-6db4-49bb-bcd2-05c14d224c70

## 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

This isn't a pitch deck. Our platform is live in production inside major US health systems — including Intermountain Health — where our AI handles real patient communication over voice and SMS and plugs directly into Epic workflows. We have a public partnership with Amazon Pharmacy. We raised a $20M Series A led by Define Ventures. Our CEO is a 2x founder; our VP of Engineering came from DeepMind. We're ~70 people, past PMF, with enterprise customers pulling us forward faster than we can hire.

This is the most senior IC role in our US org — and we mean IC. You'll own architecture across multiple product areas, designing systems that can support 10–100x growth without a rewrite. But when the hardest problem in the company needs solving, you're the one who opens the editor and builds the first version. If your last few years have been slide decks and steering committees, this isn't the role. If you've been the person who prototyped the thing everyone said was impossible, keep reading.

You'll work directly with our VP of Engineering and CEO — but nobody here manages from a distance, at any level, and the Principal is no exception.

The technical problems you'd own

- Agentic AI in a regulated environment: voice and SMS agents interacting with real patients, with the evals, guardrails and pharmacist-oversight architecture that makes that safe. This is the hard version of applied AI — the version where "it hallucinated" isn't a funny screenshot
- Deep EHR integration: Epic queues, prior authorization automation, 340B compliance — systems where correctness genuinely matters and the specs were written before you graduated
- Target-state architecture for the platform as it scales from a handful of health systems to hundreds — and building the first mile of the migration yourself
- Our AI engineering itself: model selection, context management, cost/latency tradeoffs, evaluation methodology

## What we're looking for

- A deep engineering background is non-negotiable. You've built serious systems with your own hands, recently — not managed people who did — and you can go toe-to-toe on the details of anything you've shipped
- You've operated at Staff+ level somewhere with a genuinely high bar, and can point at architectural decisions a company still runs on
- Hands-on fluency with applied AI — you've built with LLMs in production, not just read about them
- High agency. You find the highest-leverage problem in the org and go solve it — nobody points you at it

The practical stuff

We're remote-first across the US, though we've just opened a hub in Orlando if you ever wanted your comp to survive contact with your cost of living. And it's early enough that the equity is founding-role equity, not a rounding error.

## 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
- [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
- [Principal Software Engineer](https://feeny.ai/job/principal-software-engineer-foundation-health-orlando-5t23nwvgf9y1) — Orlando, FL
- [QA Lead](https://feeny.ai/job/qa-lead-foundation-health-united-kingdom-6kv3x4kpgvej) — United Kingdom
- [Staff Software Engineer](https://feeny.ai/job/staff-software-engineer-foundation-health-united-kingdom-cy1g7z2gahkd) — United Kingdom
- [Product Manager](https://feeny.ai/job/product-manager-foundation-health-united-states-rmyzekh1fhhv) — United States
- [QA Engineer](https://feeny.ai/job/qa-engineer-foundation-health-manchester-snyaj7946mjr) — Manchester