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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 Staff IT Systems Engineer to design, automate, and scale the core infrastructure that powers our company. This is a builder-first role where IT is treated as an engineering discipline. This person will drive platform maturity through API integrations, identity lifecycle automation, and code-driven workflows to ensure our teams operate securely and at peak efficiency, while raising the technical bar of the IT organization through mentorship, standards, and scalable systems design.
Design, build, and own automation across core IT systems to reduce manual work and improve reliability. Develop API-driven integrations and workflows across systems like Okta, Google Workspace, Slack, and other SaaS tools. Build and scale identity lifecycle automation (joiner, mover, leaver) with a strong focus on security and efficiency. Act as an escalation point for complex technical issues, debugging across systems, integrations, and environments. Identify recurring issues and eliminate root causes through automation and system design improvements. Partner cross-functionally with IT, Security, and business teams to design scalable solutions and improve core systems. Establish technical standards, operational rigor, and engineering best practices across the IT organization, and mentor team members on automation, infrastructure-as-code, integrations, and scalable systems design. What You Need 8+ years of experience in IT, systems engineering, or a related role with a strong automation-first mindset. Comfortable building and maintaining automation using scripting or coding languages such as Python, TypeScript, or similar, with familiarity working in Git-based development workflows. Experience building API-based integrations (REST APIs, webhooks, and event-driven workflows) across SaaS tools. Hands-on experience with IAM platforms (Okta or similar) and automation tools (Okta Workflows, Tines, etc.). Strong experience administering SaaS environments (Google Workspace, Slack, Zoom) and debugging complex, cross-system issues. Solid foundation in networking, security, and infrastructure-as-code (e.g. Terraform), with a bias toward systems built and managed through code. 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 $190,000 – $230,000 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.