Lead Software Engineer

AEP Hawaii is partnering with Ecos Health, a Hawaii-based early stage startup to hire Lead Software Engineer on Oahu as they raise their first round of capital.

Lead Software Engineer – Ecos Health

Location: Hawaii (Hybrid / Honolulu)

Role Type: Contract or part-time initially, with potential to grow into a larger leadership role

About Ecos Health:

Ecos Health is building a new kind of healthcare operations platform: an active coordination layer for care delivery. Most healthcare software is record-centered. It documents what happened. Ecos is action-centered. It helps coordinate what needs to happen, who needs to do it, when it needs to happen, what data or evidence is produced, and what obligations remain open.

Our core system, Thwe, is already working in simulation form. It is not a conventional CRUD healthcare application, and it is not simply a task manager, care coordination board, rules engine, EHR-lite system, or AI wrapper. It combines workflow execution, actor coordination, protocol management, live operational state, data provenance, simulation, user experience, and AI/LLM actor orchestration.

We are looking for a hands-on technical leader to help turn this working architecture into a robust, extensible, pilot-ready product platform.

Our Mission:

Healthcare does not mainly fail because people do not care. It fails because complex clinical and operational work is poorly coordinated, obligations are invisible, data is detached from action, and important things get dropped.

Ecos is being built to change that. We are creating software that helps clinical teams see what is happening, what needs attention, who needs to act, what has been completed, what remains unresolved, and how each piece of data or evidence came into being. And critically, it provides the place for LLMs to live and interact with the many actors and processes doing patient care. The goal is to make care delivery better: more coordinated, accountable, humane, and reliable.

The Role: Lead Software Engineer / Founding Technical Lead

This is a deeply hands-on architecture and product engineering role. You will work directly with the founder to understand the existing Thwe system, identify the core primitives that must be preserved, improve the architecture, reduce fragility, create clearer technical boundaries, and help define the path from simulation to pilot-readiness.

This is not a “build everything from scratch” role. There is already a working system with substantial conceptual depth. The right person will not reflexively throw it away or reduce it to a familiar pattern. The first job is to understand what is already there: what is essential, what is fragile, what should be refactored, what should be rebuilt, and what should be deferred.

Over time, this person may help recruit and guide additional engineers. But early on, the role requires someone who can both see the architecture and work directly in the code.

Key Responsibilities:

• Strengthen the Core Architecture: Understand the existing Thwe system deeply, identify its essential primitives, and help turn the current working architecture into a robust, extensible platform without flattening what makes it distinctive.
• Refactor and Stabilize: Improve the current codebase by clarifying boundaries, reducing fragility, strengthening state management, improving observability, and making silent failures much harder to miss.
• Workflow and Actor Coordination: Advance the engine that coordinates protocols, actions, actors, dependencies, workflow instances, patient journeys, and data provenance across simulated and pilot-ready environments.
• Product-Focused Engineering: Help shape the Control Tower and related interfaces so the system makes live coordination visible, understandable, calm, and useful rather than feeling like a static dashboard.
• Hands-on Technical Leadership: Write high-quality code, guide architecture decisions, establish practical engineering standards, and help define the next technical hires as Ecos moves from prototype toward pilot-readiness.

Who You Are:

• Systems-Minded Builder: You have strong backend and architecture skills, and you are drawn to complex stateful systems, workflow engines, orchestration, event-driven systems, simulation, or similar technical problems.
• Respectful of Existing Depth: You do not reflexively rebuild from scratch. You know how to understand an existing codebase, separate essential architecture from prototype artifacts, and improve the system without losing its conceptual heart.
• Rigorous and Observable: You care about debugging, testing, logs, traceability, failure recovery, and making complex systems understandable and reliable.
• Product-Sensitive Engineer: You care that software is not merely functional, but clear, humane, elegant, and trusted by real users doing important work.
• Mission-Driven Technical Leader: You are curious, humble, technically strong, comfortable with ambiguity, able to challenge assumptions constructively, and motivated by building software that can improve healthcare.

Why Join Us?

• High Ownership: Significant influence over technical architecture, product direction, and the ability to choose the supplementary tech stack.
• Mission-Driven Work: Solve problems at the intersection of healthcare and AI that directly impact patient outcomes and lives.