Director of Engineering

TRELLIS BUILDS AND DEPLOYS SELF-IMPROVING AGENTS TO GET PATIENTS ACCESS TO LIFE-SAVING MEDICINE.

Our AI agents process billions of dollars worth of therapies annually with patients in all fifty states. We do this by automating document intake, prior authorizations, and appeals at scale to streamline operations and accelerate care. We classify medical referrals, understand chart notes, and automate contract and reimbursement search to provide patients with accurate coverage determinations and cost responsibility. Think of us as the infrastructure behind how patients get their medications.

Trellis is a spinout from Stanford AI Lab and is backed by leading investors including YC, General Catalyst, Telesoft Partners, and executives at Google and Salesforce.

THE ROLE

We went from 6 to 8 figures of revenue in less than a year. Engineering is 15 people today in three pods (platform, deployed, and product), and we want to double the team by the end of the year. We're hiring a Director of Engineering to lead that growth and help us scale from here.

The question we're hiring against: what would someone who has taken a company from zero to nine figures in two or three years want to change here? You'll set the engineering bar, make the high-leverage technical and organizational calls, and build a team that ships fast without breaking the things patients depend on. You'll report to Jacky (Co-founder & CTO).

WHAT YOU'LL DO

- Scale the team: Hire, onboard, and grow engineers and engineering managers as we double headcount, and set the bar for who we hire

- Set how we build: Own engineering practices, including dev environments, testing, code review, and how we ship, so the team gets faster as it grows

- Make the big technical calls: Drive architecture and vendor decisions across our agent platform, Windows session fleet, and integrations (TypeScript, AWS, Temporal)

- Keep the system reliable: Make sure our infrastructure scales past the $10B of therapies we process today

- Unblock the team: Remove what slows engineers down, and keep platform, deployed, and product pods aligned on what matters most

- Partner across the company: Work with the founders, deployments, and GTM to turn customer needs into a roadmap the team can deliver

ABOUT YOU

You're early in a steep career curve: you've grown fast because you're very good, not because you've waited your turn. You've led engineering at an early-stage company that moved quickly, and you still like being close to the code. You want to build the team and the culture, not inherit a process.

WHAT YOU'LL BRING

- Experience leading engineering teams at a fast-growing early-stage startup (seed to Series B), ideally through a period of rapid headcount growth

- A strong technical background and credibility with senior engineers; you can still go deep on architecture

- A track record of hiring and developing great engineers

- Experience setting engineering practices that increased speed and quality

- Experience with distributed systems, cloud infrastructure, or AI/agentic products is a plus

- Healthcare experience is a plus

- High ownership, clear communication, and comfort with ambiguity

WHY WORK WITH US

- Real impact at massive scale: We serve patients in all fifty states and are scaling to hundreds of healthcare locations. When the team ships, thousands of patients feel it the next day.

- Incredible growth and traction: We've grown revenue 10x in the past few months alone.

- Work with the founding team: Partner directly with founders and F500 customers, alongside healthcare operations leaders who have overseen 50+ locations.

- Be at the forefront of AI in healthcare: Work on production-grade agentic systems that make critical healthcare decisions, not a demo.

- World-class team: Join teammates who have won international physics olympiads, published economics research, were founding engineers at unicorn startups, and taught A