AI Engineer

About Pair Team Pair Team is building a new kind of healthcare system across Medicaid, Medicare, and public assistance programs: one that recognizes that access to housing, nutritious food, and reliable transportation are just as critical to health as having the right medications or seeing a doctor. As a public benefit corporation and AI-enabled medical group, we partner with shelters, food pantries, and community organizations to deliver "whole-person" care to the 115 million Americans who rely on the safety net. We are currently the largest complex care provider in California with over 500 employees and are expanding nationally. Our model replaces fragmented healthcare and social services systems with one trusted relationship for all medical, behavioral, and social needs. We improve access, build trust, and dramatically lower costs (52% fewer ER visits, 26% fewer hospitalizations). Our model is a rare combination of saving tax payer dollars ($150B annually at scale) while putting people on an upward life trajectory. At national scale, this approach would save taxpayers. These outcomes are driven by the AI-first, whole-person infrastructure we are building — a platform that connects healthcare and social-service organizations into a unified network. Leveraging our vast data and years of operational experience, we are building the agentic infrastructure for the safety net to coordinate care, automate operations, and learn from every patient interaction to continuously improve outcomes. Read more about the AI-First Medicaid System we are building here. • Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most • TechCrunch: Building for Medicaid's regulatory moment with Neil Batlivala from Pair Team • Journal of General Internal Medicine: A Novel Intervention for Medicaid Beneficiaries with Complex Needs About the Role As a Principal AI Engineer, you will help design and build the architecture that enables this evolution, translating complex care processes into reliable, production-grade AI systems in close partnership with product and domain experts. What You'll Do • Lead the design and evolution of agentic systems that participate directly in care delivery, helping coordinate care, engage patients, and execute meaningful portions of care workflows. • Define and build architectural patterns for agent reasoning, tool use, memory, and human-in-the-loop collaboration. • Develop both reusable platform capabilities and product-facing implementations, balancing long-term architecture with rapid iteration. • Own complex problem spaces end-to-end — from system design and implementation through observability, evaluation, and continuous improvement in production. • Partner closely with product managers, operators, and domain experts to translate complex real-world processes into reliable agent behavior. • Establish standards and best practices for agent evaluation, safety, and operational reliability as these systems evolve toward greater autonomy • Mentor engineers and influence technical direction across teams building agent-driven capabilities. Who You Are • Systems-Oriented Technical Leader: You think in systems, not features. You make strong architectural decisions, navigate trade-offs effectively, and help shape technical direction across teams. • Applied Agentic AI Builder: You've built and scaled production agentic AI systems that perform meaningful work beyond simple chat interfaces. You understand agent behavior, tool orchestration, stateful workflows, and the realities of operating AI systems in production. • Product-Minded Engineer: You work closely with product managers and domain experts to define problems and translate ambiguity into clear technical solutions. You care about outcomes, not just implementation. • Strong Judgment in Ambiguity: You're comfortable operating in evolving problem spaces, balancing experimentation with reliability and knowing when to prioritize speed versus long-term investment. • Data & Evaluation Driven: You use metrics, evaluation frameworks, and operational feedback to guide decisions and continuously improve system performance. • Highly Autonomous Executor: You take ownership of complex problem spaces end-to-end, balancing speed with engineering rigor and iterating effectively based on real-world feedback. • Multiplying Presence: You elevate those around you — mentoring engineers, establishing best practices, and helping raise the bar for how AI systems are designed and operated. What You'll Need  • 6+ years of experience building and shipping production software systems, including experience operating at a Staff or Principal IC level and driving technical direction across complex systems • Proven experience building and scaling multi-agent or agent-driven systems in production and real-world operational ownership (beyond simple chat or LLM workflows). • Hands-on experience with modern agent ecosystems,