About Fira Health
Fira Health builds AI-native infrastructure to automate the administrative backbone of healthcare. We’re starting with home health, helping agencies reduce overhead, accelerate payments, and focus more on care—not paperwork. Our agentic AI platform integrates directly into providers’ operations, automating complex workflows like insurance verification, prior authorization, and billing.
Fira is backed by top-tier investors and built by a team with deep expertise across healthcare operations, applied AI, and complex workflow automation.
About the Role
We're hiring an Infrastructure Engineer to build and scale the foundational systems that power Fira's AI automation platform. You'll own critical infrastructure that supports our production workloads across intake, clinical documentation, and revenue cycle management—ensuring reliability, security, and performance as we scale from one client to dozens.
A successful Infrastructure Engineer at Fira is systems-oriented, and comfortable working across the stack—from container orchestration and data pipelines to observability and deployment automation. You'll have significant ownership over architecture decisions and the opportunity to shape how we build resilient, compliant infrastructure for healthcare.
Over time, you'll set the technical vision for our infrastructure layer, define operational best practices, and lead critical initiatives that enable the entire engineering organization to ship faster and more reliably.
Responsibilities
Design, build, and maintain scalable cloud infrastructure on AWS, including container orchestration (ECS), databases (Postgres, Redshift), and data pipelines that support our AI-driven automation platform.
Own CI/CD pipelines and deployment automation, ensuring fast, safe releases with proper testing, rollback capabilities, and zero-downtime deployments.
Implement and manage infrastructure-as-code using Terraform, ensuring consistency, repeatability, and version control across all environments.
Build comprehensive observability and monitoring systems using tools like Datadog, tracking system health, performance metrics, and cost optimization opportunities.
Scale and optimize database systems (Postgres, Redshift) to handle growing data volumes while maintaining query performance and data integrity.
Ensure security and compliance at the infrastructure layer, implementing IAM policies, network security, audit logging, and HIPAA-compliant data handling.
Qualifications
Infrastructure Experience: 4+ years of infrastructure or platform engineering experience, with proven ability to build and scale production systems in fast-paced environments.
AWS Expertise: Strong hands-on experience with Terraform and AWS services, including ECS (container orchestration), RDS/Postgres, Redshift, IAM, VPC, and other core AWS primitives
CI/CD & Deployment: Strong experience building and maintaining CI/CD pipelines, automated testing, and deployment automation to enable fast, reliable releases.
Observability & Monitoring: Hands-on experience with monitoring and observability tools like Datadog, including metrics, logging, tracing, and alerting strategies.
Collaboration & Communication: Excellent ability to partner with engineering teams to translate product and technical requirements into reliable infrastructure solutions.
Preferred:
Familiarity with Redshift or similar data warehousing solutions for analytics and reporting workloads.
Experience in healthcare technology or other highly regulated industries requiring strict security and compliance standards.
Familiarity with data pipeline orchestration tools and ETL/ELT patterns for analytics workloads.
Background in SRE practices, including incident response, post-mortems, and reliability engineering.
We are fixing US healthcare by building an AI-native physical care platform, starting with home health.
Home health is a $140B industry with less than $10B in EBITDA — 40% of revenue is spent on pure administrative waste. We automate this work with AI, creating a fundamentally different cost structure compared to incumbents. This lets us rapidly take market share by serving the 30% of patients who go untreated today.
We've built one of the best AI teams in the world (from Character AI, Scale, Palantir, Citadel, Jane Street) and paired them with a team of healthcare veterans and strategists to build a new type of healthcare company: one that delivers care at the speed of an AI company.
Our physical care platform already operates with 30pp higher gross margins than traditional home health providers. With our AI advantage, we pay nurses more, remove their admin burden, and unlock the scale economics that have been missing from this fragmented industry.
We're starting with home health, then expanding to all delivered care. Our mission is "any care, any where".
Fundamentally, our incentives are aligned with America. Every dollar in revenue we make is two dollars taken out of the healthcare system. If we succeed, so does US healthcare.
Team size
400 employeesFounded
Website
www.firahealth.com/Company locations
Ryan Tolsma - Founder, CTO @ Fira Health
Alex Wendland - Founder, CEO @ Fira Health