Director, Engineering

Fold Health | Pune, India (In-Office) | Full-Time

Experience: 12-18 Years | Reports to: VP, Engineering

Domain: US Healthcare (Value-Based Care / Population Health / HealthTech preferred)

About Fold Health

Fold Health is building an AI-powered orchestration platform for value-based care. We don't just analyze healthcare data; we enable AI agents to execute complete workflows across care delivery, from patient outreach to claims processing to care coordination.

We process and normalize diverse healthcare datasets (EHR, claims, ADT, CRM, transactional, and third-party sources) into a unified data model that powers advanced analytics, AI/LLMs, and BI. Our customers include IPAs, ACOs, national enablers, health systems, MSOs, and payers across the US.

We are a well-funded startup backed by leading investors, building in Pune for the US healthcare market. This is a high-ownership, high-impact role where you will shape engineering culture, architecture, and team from the ground up.

The Role

We are looking for a Director of Engineering to own and scale Fold Health's engineering organization from our Pune office. This is not a maintenance role. You will be building: building teams, building architecture, building processes, and building a culture of engineering excellence for a platform that directly impacts patient outcomes.

You will operate with significant autonomy during India hours, partnering closely with US-based product, data, and business leadership across time zones. You will own engineering delivery end-to-end while collaborating on product strategy and technical vision.

What You Will Own

Engineering Leadership and Team Building

• Define and execute the engineering roadmap aligned with product and business strategy
  

• Lead and grow multiple engineering teams across:
  

• Backend microservices (Node.js / NestJS)
  

• Frontend (ReactJS, React Native)
  

• Python-based services and AWS Lambda functions
  

• Data pipelines (GCP FHIR Store, BigQuery, Postgres)
  

• Scale the Pune engineering team from current state to 25+ engineers; own hiring, retention, and performance
  

• Establish engineering career ladders, performance frameworks, and a culture of ownership and accountability
  

• Mentor Engineering Managers and Tech Leads to build leadership depth
  

Architecture, Platform, and Reliability

• Own architecture decisions across a dual-cloud environment (AWS + GCP)
  

• Drive reliability, scalability, and high availability of distributed systems
  

• Optimize healthcare data ingestion pipelines: FHIR, HL7, X12 EDI (837/835), ADT feeds
  

• Manage cloud spend, make build-vs-buy decisions, and evaluate vendor partnerships
  

• Strengthen observability, monitoring, alerting, and incident response across time zones
  

• Reduce technical debt systematically while maintaining delivery velocity
  

Healthcare Compliance and Security

• Ensure HIPAA-compliant architecture and PHI/PII data security practices
  

• Drive HITRUST certification readiness and SOC 2 Type II compliance
  

• Oversee EHR integrations (Elation, Athena, eCW, Epic, Cerner, etc), HIE feeds, claims pipelines, and CRM integrations
  

• Implement and enforce access control, audit logging, encryption, and vulnerability management
  

AI and Product Innovation

• Partner with AI/ML teams to productize LLM-powered healthcare agents that execute real workflows (not just analytics)
  

• Enable feature engineering pipelines and analytics infrastructure for care coordination and population health
  

• Evaluate emerging healthcare AI technologies to maintain competitive edge
  

Operational Excellence

• Improve SDLC maturity: CI/CD automation, testing culture, code review standards, DevOps practices
  

• Define and track engineering KPIs: velocity, quality, reliability, and developer experience
  

• Own incident management, root cause analysis, and production support processes
  

• Manage engineering budget, cloud infrastructure costs, and vendor relationships
  

  
  
  

Requirements

Requirements

• 12-18 years of hands-on software engineering experience, with 5+ years in senior engineering leadership (Director / Sr. Manager level)
  

• Proven experience building and scaling engineering teams (20+ engineers) in a product company
  

• Strong distributed systems and microservices architecture background
  

• Deep experience with:
  

• Node.js (NestJS