Founding Head of Engineering and AI of a Seed Stage Startup

Founding Head of Engineering and AI

Total Life · Seed Stage · Equity Package · Full-Time · In Office (Vancouver) / Hybrid ok

About Total Life

Total Life is a national behavioral health telehealth platform built for adults later in life, the fastest-growing and most underserved population in American healthcare. We offer therapy in all 50 states plus Washington, DC, through a network of 200+ licensed clinicians. We have expanded into psychiatry, longevity, weight loss and cognitive care, and we bill Original Medicare Part B directly. We are in-network nationally with Aetna, Cigna, UnitedHealthcare and Humana, and with most Blue Cross Blue Shield and regional plans.

We are growing quickly. Total Life ranks in the top 10 of the Deloitte Technology Fast 50 (Canada) and #5 in healthcare on the Inc. 5000. We have also been named to the C100 and are a member of the AARP AgeTech Collaborative. We are now entering our next phase of hypergrowth, and we need a technical leader to build what comes next.

The Role

This is not a CTO role where you manage from a distance. We want a builder-leader who will write production code every week and also set the technical vision for the company. You will work directly with leadership, on the strategic roadmap. You will own the architecture, and you will build AI-first systems that change how older adults find, start and stay in care.

The role is high-profile, high-impact and hands-on. It suits someone who is all in, energized by an intense, fast-moving environment, and excited to build a category-defining company from the ground up.

What You'll Do

Build and ship. You will write, review and ship code across the stack. Over the past year we built our native systems, which gives us full control over patient engagement, agentic workflows and a multi-specialty care experience. You'll take that platform to its next level.

Lead AI-first product development. You will design and scale AI systems that run in real clinical and operational workflows. One example is Lily, our AI companion, which calls patients to schedule appointments, send medication reminders, run screenings and coach CBT exercises. You'll also build intelligent intake, automated eligibility and agentic back-office operations.

Co-own the strategic roadmap. You will partner with leadership turn company strategy into a technical roadmap. That includes build-vs-buy decisions, sequencing, platform bets and the long-term vision of Total Life as the infrastructure other behavioral health practices can run on.

Champion product design and customer experience. Our patients are older adults, and many are new to telehealth. You'll bring a sharp design eye to every patient, clinician and partner touchpoint, so that the product is simple, warm and accessible.

Engineer for growth and engagement. You will build the features and tools that drive acquisition, activation, retention and session completion. Examples include referral loops, partner dashboards, re-engagement flows, and in-platform experiences that keep patients connected to their care.

Integrate marketing technology. You will connect the platform to our growth engine, including attribution, CRM, messaging, conversion funnels and paid acquisition data, so that marketing and product run on one source of truth.

Own healthcare infrastructure. You will lead our work on payer and eligibility integrations (including CMS HETS 270/271), interoperability, senior-living integrations such as PointClickCare, and revenue cycle data flows.

Secure and scale the platform. You will keep HIPAA compliance, security, uptime and data integrity strong as our patient volume, states and service lines grow.

Build and lead the team. You will set the engineering culture, raise the bar for quality and speed, manage in-house and contract developers, and hire the team that will carry us through Series A and beyond.

To Apply

Send your resume along with a few sentences about something you've built that you're proud of, and why this role excites you. Links to GitHub, shipped products or portfolio work are encouraged.

Requirements

What You Bring

You have 8+ years of software engineering experience, including meaningful time as a technical leader (CTO, VP Engineering, founding engineer or head of engineering) at a startup or high-growth company.

You are still an active hands-on coder and enjoy shipping. You have deep experience with modern backend systems, cloud infrastructure and API design. Experience with Go is a strong plus, along with fluency in modern frontend frameworks.

You have shipped AI and LLM-powered products in production, including agentic workflows, voice or conversational AI, and retrieval systems. You understand both their potential and their failure modes.

You have strong product and design instincts. You care how things look and feel, and you can tell when a feature will drive engagement and when it won't.

You have a track record of building systems from zero to one and then scaling them through rapid growth.

You can translate between business strategy and technical execution, and you can communicate clearly with the CEO, clinicians, partners and investors.

You thrive with ambiguity, urgency and ownership, and you want to be in the arena.

Huge Pluses

Healthcare technology experience is a major plus, especially EHRs, telehealth, HIPAA, HL7/FHIR, payer integrations, eligibility and claims, or revenue cycle systems. So is experience with marketing technology and growth infrastructure, such as attribution, CRM platforms, lifecycle messaging and experimentation frameworks. We also value experience building products for older adults, caregivers or accessibility-first audiences, experience at a startup through a Series A or later raise, and background in behavioral health, Medicare or value-based care.

Benefits

Why Total Life

You'll do meaningful work. Behavioral health for older adults is one of the largest unmet needs in American healthcare, and your work will directly improve access to care for people who have long been overlooked.

You'll join proven momentum. We are nationally recognized as one of the fastest-growing companies in North America, with a national clinician network and broad insurance coverage already in place.

You'll have real ownership. As CTO you'll hold a seat at the leadership table, have a direct line to the CEO, and shape both the technology and the company.

You'll get meaningful equity. We offer a competitive salary and significant equity in a company at an inflection point.

You'll build from the ground floor. This is the chance to architect the platform that defines tech-enabled care for aging adults.