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Cadence is the clinical AI company automating the treatment of chronic disease. Its Clinical Intelligence takes on the routine, high-volume work of chronic care – monitoring patients, surfacing risks, and coordinating action – so clinicians can focus on the decisions that require them. Grounded in partnerships with more than 20 leading health systems, deep EMR integrations, dedicated medical group, and experience serving a population of more than 100,000 patients, the system learns from real-world care delivery, improving as it scales. Cadence has been recognized by TIME as one of the Top 100 HealthTech Companies and by LinkedIn as a Top Startup (#4, 2025). The Role We're hiring a Senior IT Systems Engineer to design, automate, and scale the core infrastructure that powers our company. This is an engineering discipline role where the expectation is code driven systems, not ticket driven operations. This person will contribute to platform maturity through API integrations, identity lifecycle automation, and scalable workflow design with a direct impact on how Cadence's clinical and operational teams function every day.
Design, build, and own automation across core IT systems to reduce manual work, improve reliability, and scale with the organization. Develop API-driven integrations and event-based workflows across platforms including Okta, Google Workspace, Slack, and other critical SaaS tools. Build and scale identity lifecycle automation covering joiner, mover, and leaver workflows with a strong focus on security and operational efficiency. Contribute to root cause resolution for recurring technical issues, eliminating failure points through system design and automation rather than repeated manual intervention. Strengthen the technical quality of IT systems through rigorous code review, thorough documentation, and repeatable automation patterns. Serve as the escalation point for complex cross system issues, debugging across integrations, environments, and SaaS platforms with minimal support. Partner with IT, Security, and business stakeholders to evaluate, design, and deliver scalable infrastructure solutions that meet clinical and operational requirements. What You Need 5+ years of experience in IT systems engineering or a closely related role, with a demonstrated automation-first approach to infrastructure problems. Proficiency building and maintaining automation using scripting or coding languages such as Python, TypeScript, or similar, with experience in Git-based development workflows. Experience designing and implementing API-based integrations including REST APIs, webhooks, and event-driven workflows across SaaS environments. Hands-on experience with IAM platforms such as Okta and automation tooling such as Okta Workflows, Tines, or comparable platforms. Strong experience administering SaaS environments including Google Workspace, Slack, and Zoom, with the ability to debug complex, cross-system issues independently. Demonstrated experience with networking fundamentals, security principles, and infrastructure-as-code tooling such as Terraform. Fluency with LLM APIs, prompt engineering, and AI-assisted development tools; demonstrated experience building or evaluating AI-powered systems in production. Compensation Our job titles may span more than one career level. The base salary for this role typically ranges between $160,000 – $200,000 depending on experience, skills, seniority, and business needs. In addition to base salary, this role may be eligible for equity as part of the total compensation package. Actual compensation may vary by location.
Competitive pay & equity* Fully remote Comprehensive health coverage: Medical, dental & vision Paid time off 401k plan + matching Paid parental leave Home office stipend *benefit offerings may vary depending on job profile, job level and worker type Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws. A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team. Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence. If you require a reasonable accommodation during the interview or hiring process, please notify your recruiter.