Pelago is the leading specialty substance use care provider, built on the belief that effective treatment means matching care intensity to what each member actually needs rather than defaulting to the most expensive intervention. Our programs guide members through every stage of the substance use spectrum, from unhealthy habits to active use disorders, delivering personalized treatment for tobacco, alcohol, opioid, cannabis, and stimulant use based on individual health, habits, genetics, and goals.
With Sona, our voice-first AI Mental Health Specialist, Pelago now applies that same clinically-driven model to mental health, pairing deep clinical expertise with technology to expand access without compromising care quality. We believe technology should make clinical care more precise and more human, not replace the judgment behind it.
Pelago has scaled to helping hundreds of employers and health plans and has already helped more than 750,000 members better manage their substance use. If you're passionate about AI and making an impact on the health of others, join us and make it happen!
About Pelago Engineering:
Our engineering team operates as empowered, outcome-oriented problem solvers, working in close partnership with product, design, and clinical teams to improve member outcomes at scale.
As AI transforms how software is built, we are intentionally evolving our development lifecycle so we spend less time on mechanical implementation and more time on system design, judgment, and impact.
How We Work:
- Outcome-driven: Engineers are given problems to solve, not just features to build. Success is measured by learning, impact, and outcomes—not velocity alone
- AI-native: We use AI across the SDLC to accelerate implementation, testing, and review. Engineers focus on defining intent, validating behavior, and designing resilient systems
- High autonomy, high accountability: Teams have real ownership over their domains. With autonomy comes responsibility for quality, safety, and results
- Cross-functional by default: Engineers partner deeply with Product, Design, Data, and Clinical. Discovery, experimentation, and delivery are shared responsibilities
- Quality and safety matter: We build in a regulated, member-impacting domain. Reliability, observability, and correctness are first-class concerns
What You’ll Do:
Instead of task lists, anchor on ownership:
- Own meaningful problem spaces end-to-end, from discovery through delivery and iteration
- Design and evolve systems that support safe, scalable, AI-augmented development
- Use data and experimentation to validate whether solutions actually work
- Collaborate cross-functionally to balance member impact, clinical constraints, and technical tradeoffs
- Shape how we work—our tools, processes, and culture
What We Look For:
We explicitly assess for empowerment:
- You start with "why" before diving into "how"
- You're energized by ambiguity and collaborative problem-shaping
- You use AI to amplify your judgment and move faster on what matters
- You think in systems and anticipate second-order effects
- You want to own outcomes, not just ship features
Overview of the Role:
Pelago is building behavioral health care delivery from the ground up – AI-native, outcome-oriented, and built for a domain where what you ship has direct consequences for member health. Product Engineers own meaningful problems end-to-end: from discovery through production and iteration, in close partnership with product, design, data, and clinical stakeholders. The hire we're looking for is technically strong enough to ship across the stack, fluent enough with AI tooling to move fast, and grounded enough to make sound trade-offs in an environment where member safety, privacy, and reliability matter as much as speed.
In This Role You Will:
- Own meaningful product areas end-to-end — from problem framing and prototype through production rollout and iteration.
- Partner deeply with product, design, data, and clinical teams to shape solutions that improve member outcomes and business results.
- Build and evolve secure, well-tested, observable software across backend, frontend, and data surfaces.
- Use data, experimentation, and user feedback to validate whether shipped solutions are working, and drive iteration when they're not.
- Operate autonomously in ambiguous environments, communicating proactively across globally distributed teams and functions.
- Make sound trade-offs across speed, safety, technical quality, and maintainability in a regulated environment.
- Improve Pelago's engineering system: AI-native development practices, testing, documentation, knowledge sharing, and review quality.
The Background We're Looking For:
- Strong production experience building product software in a startup or scale-up environment.
- Excellent TypeScript/Node capability; comfortable working across APIs, services, data and cloud infrastructure.
- Strong product sense: able to start from the user or business problem, not just the implementation.
- Comfortable operating autonomously in ambiguous environments and making sound trade-offs with incomplete information.
- Solid testing, observability, and reliability instincts.
- Fluent with AI-augmented engineering workflows while maintaining human judgment and QA discipline.
Nice-to-have skills
- Experience in healthcare, digital health, or safety-sensitive regulated software.
- Experience with event-driven systems, serverless AWS, relational database design, and infrastructure as code.
- Experience with experimentation, analytics, and growth/product instrumentation.
- Experience contributing to both backend and user-facing product surfaces.
- Experience building products from 0 to 1 in an early-stage environment
At this time, we are unable to offer visa sponsorship for this position.
Please note that Pelago is dedicated to providing accommodations to candidates upon request. If you need accommodations at any point throughout the interview process, please reach out to your recruiter.
Before you apply, see how we build.
We write about our technical decisions, product philosophy, and the real challenges of scaling behavioral health. Read the blog → https://pelagohealth.ai/