Founding Full Stack Engineer

Posted for Kanurra on behalf of Oak Recruiting. Founding Full Stack Engineer (full stack software engineer), full-time, New York, NY. Kanurra is a venture-backed, AI-native pharmacy benefit manager, and this is their very first engineering hire.

Location: New York, NY (in office, core hours with flex). NYC metro strongly preferred; exceptional remote candidates considered with on-site presence expected around the January go-live. Reports to: the CEO

Work authorization: Unfortunately, visa sponsorship and visa transfers are not offered for this role. Applicants must be authorized to work in the US without sponsorship, now and in the future.

About Kanurra

Kanurra is a pass-through pharmacy benefit manager for small and mid-size employer groups. Employers pay a flat per-member-per-month administrative fee, the plan pays the network's contracted rate with no spread retained, and rebates flow to the plan sponsor rather than into Kanurra's margin.

The reason a company this small can run a PBM at all is that software takes the cost-to-serve down by an order of magnitude. That is the whole thesis. You are the person who builds it.

Kanurra is pre-launch and venture-backed, targeting a January 1 effective date for its first groups. You would be joining before the first live claim.

The role

You are the first of a small team, with one or two more engineers expected to follow behind you. You own delivery of the entire product surface. The CEO is a working engineer who owns product and design and will be in the code with you. You are not walking into a blank technical canvas, and you are not walking into a finished one either.

Because you are first, you set the conventions the next engineers inherit: repo structure, agent context, test discipline, what gets reviewed and how. That is a real part of the job, not an afterthought.

How the team builds

Kanurra builds with coding agents as the default, not as an occasional assist. One engineer has to cover what would conventionally take three, and leverage is the only way that works. One standard: velocity is the point, unexplained code is not. Anything you ship, you can defend line by line.

On disagreement: the CEO has been building alone, which means plenty of architectural decisions nobody has pushed back on, and some of them are wrong. Strong opinions, loosely held, on both sides. The first engineer is someone who argues, brings the evidence, and stays in it until one of you actually changes position. You are not being hired to implement decisions. You are being hired to make them better and sometimes to overturn them.

What you will own

• The member application. What a covered employee sees and uses: card, coverage, what a drug costs and where to get it.
• The APIs the application runs on, and the data model underneath.
• Adjudication engine integration. Eligibility ingestion from employers and TPAs, normalization, the SFTP push into the platform, the daily claim extract coming back, and the warehouse and reporting built on it. This is where silent failure lives. A file that quietly drops thirty dependents does not throw an error, it shows up as members turned away at a pharmacy counter.
• Prior authorization plumbing. Intake, criteria matching, routing, determination, the turnaround clock. The CEO guides the clinical logic. You build the machine it runs in.
• Vendor integrations. Drug data, specialty pharmacy partners, and whatever else the business signs.
• Everything else. The long tail is long. Some of it is fascinating and some of it is a CSV that has to parse correctly at 6am.

Sequencing

Before the first live group in January: eligibility in, claims out, a member can see their coverage, and a prior authorization can be received, routed, decided and communicated. That is the bar. After that: the full member experience, price transparency, deeper vendor integrations, and the self-serve tooling that feeds sales. The team would rather ship the January four correctly than have eight things half-built.

What this is not

• Not a design role. The CEO owns product and design, and the design system already exists. You implement against it.
• Not a blank canvas. The CEO is a working engineer with formed opinions about how this gets built.
• Not a research role. This is shipping, under a deadline, in a regulated industry.

Tech stack and requirements

Must have

• Python (3 to 5+ years)
• TypeScript / JavaScript (3 to 5+ years)
• Postgres (3 to 5+ years). Real experience with Postgres row-level security is the differentiator here, since RLS is Kanurra's authorization substrate.
• REST API design (3 to 5+ years)
• CI/CD (3 to 5+ years)
• FastAPI (1 to 2+ years)
• OAuth (1 to 2+ years)
• Docker (1 to 2+ years)
• GCP (1 to 2+ years). Strong AWS or Azure backgrounds transfer well.

Nice to have

• Webhooks
• LLM APIs

You probably

• Have four to eight or more years building software.
• Ship a surface area that does not add up for the headcount and time you had. This is the single strongest signal.
• Are backend-leaning full stack, comfortable owning a data pipeline and a user-facing app in the same week.
• Have worked somewhere data correctness mattered and silent failure was expensive: regulated, financial, or infrastructure. Healthcare is a plus, not a requirement.
• Know nothing about pharmacy benefits and are unbothered by that, because you learn domains fast and enjoy it.
• Want to be the first engineer and understand what that costs.

Compensation

: $220,000 to $250,000

New York, New YorkInterview process

1. Intro call with the CEO. Technical from the first minute.
2. Live pairing session, ninety minutes. The real repository, a real ticket, your screen, your own setup and whatever tools you normally use. Nothing you write here ships. No take-home and no algorithm puzzle.
3. Domain reasoning exercise. A real claim rejection and a plan design with no explanation. Nobody is expected to know the answer; the team wants to see how you get there.
4. References and offer. Target time to offer is two to four weeks.

We can't wait to meet you. Easy apply below!