miramace - Senior AI Engineer — Voice & Agentic Systems

• We're looking for an AI engineer to own the loop that turns real-world patient interactions into better AI agents — from eval infrastructure to production-grade systems. You'll own the systems that make our agents smarter with every patient interaction — from the voice AI that activates patients and handles calls to insurances, vendors, and providers, to the autonomous workflows that orchestrate end-to-end care delivery. • You'll work directly with the founders to build production systems that learn and improve from real-world usage. You'll design the eval pipelines, capture the right signals from product usage, and create the reinforcement learning loops that drive continuous quality improvement across every agent we ship. • If you've built AI systems that get better with usage and want to apply that experience to healthcare — where every improvement directly impacts patient outcomes — we'd love to talk. • You've built AI agents or LLM-powered systems from scratch and shipped them to production — not just demos, but systems handling real interactions with real users at scale. • You have hands-on experience building evaluation pipelines for AI systems — designing metrics, capturing signals from production usage, and using that data to systematically improve agent quality. • You have experience with reinforcement learning from human feedback (RLHF), reward modeling, or other feedback-driven improvement loops for LLM-based systems. • You've monitored and debugged AI systems in production — you know what it takes to keep agents reliable when they're interacting with real people. • You're comfortable with ambiguity. The playbook doesn't exist yet, and you're excited to build it. • Experience in healthcare, health tech, or regulated industries (HIPAA, PHI handling). • Familiarity with Medicare, insurance workflows, or clinical operations. • Experience with voice AI systems — speech-to-text, text-to-speech, and real-time voice orchestration. • Background in RAG systems, vector databases, and knowledge retrieval pipelines. • Contributions to open-source AI projects or a portfolio of side projects that show your range. • Proactive. You move quickly and take a forceful stand without being abrasive. You act without being told what to do and bring new ideas to the company. • Analytically sharp. You structure and process qualitative or quantitative data and draw penetrating insights. You learn quickly and absorb new information with ease. • High standards with attention to detail. You expect nothing short of the best from yourself and your team. You don't let important details slip through the cracks or derail a project. • Passionate and open. You exhibit enthusiasm and a can-do attitude over your work. You solicit feedback often and react calmly to criticism or negative feedback. • Everything we do is guided by a set of leadership principles that define how we operate: • Patient First. We start with the patient and work backwards. Every decision — what we build, who we partner with, how we operate — is filtered through one question: does this make the patient's life better? • Sense of Urgency. Every day a patient goes unnavigated is a day someone needing help couldn't get the support they needed. We move fast, make decisions with conviction, and carry urgency toward the long-term vision: an AI nurse concierge in every patient's corner. • Ownership. We see things through. We don't ship and walk away — we own outcomes, not just tasks. We act on behalf of the entire company, beyond just our own area of responsibility. We never say "that's not my job." • Insist on the Highest Standards. We hold ourselves and our teams to nothing short of the best — in clinical quality, in operational execution, in how we show up for patients and partners. We raise the bar continuously. • Question Everything, Unapologetically. We reason from first principles, not precedent. We challenge requirements regardless of who set them, dig until we reach the root of the problem, and resist the pull of "that's how it's always been done."