Staff IT Systems Engineer

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Re‑architecting U.S. healthcare demands speed, precision, and an obsession with details. Cadence is building a remote care delivery system that keeps older people healthy, out of the hospital, and at home. By pairing each patient with a dedicated clinical team that reviews their health every day, versus every few months, we catch issues early and intervene before they escalate. The result: measurably better outcomes for patients and less administrative burden for clinicians.

Today, Cadence supports tens of thousands of  active patients nationwide. Our AI‑powered system and scalable clinical model enable proactive, population‑level care. We’re among the fastest‑growing companies in healthtech, and we’re just getting started.

We are seeking an Staff IT Systems Engineer to help design, automate, and scale the core infrastructure that powers our company. This is a builder-first role where IT is treated as an engineering discipline; you will drive platform maturity through API integrations, identity lifecycle automation, and code-driven workflows to ensure our teams operate securely and at peak efficiency.

This is not a traditional IT role. We’re looking for an engineer-minded systems builder who understands how modern SaaS, identity, and infrastructure systems work together and uses automation, code, and strong technical rigor to scale operations and eliminate manual work. This person will also help raise the technical bar of the IT organization through mentorship, standards, and scalable systems design.

Note: This engineer will be required to work EST/EDT business hours to provide consistent operational coverage.

WHAT YOU’LL DO:

Design, build, and own automation across core IT systems to reduce manual work and improve reliability
Develop API-driven integrations and workflows across systems like Okta, Google Workspace, Slack, and other SaaS tools
Build and scale identity lifecycle automation (joiner, mover, leaver) with a strong focus on security and efficiency
Act as an escalation point for complex technical issues, debugging across systems, integrations, and environments
Identify recurring issues and eliminate root causes through automation and system design improvements
Partner cross-functionally (IT, Security, business teams) to design scalable solutions and improve core systems
Participate in an on-call rotation and respond to critical incidents as needed, including after-hours support when required
Help establish technical standards, operational rigor, and engineering best practices across the IT organization
Mentor team members on automation, infrastructure-as-code, integrations, and scalable systems design
Contribute to and maintain code-driven operational workflows using GitHub and PR-based development practices

WHAT YOU’LL NEED:

8+ years of experience in IT, systems engineering, or a related role with a strong automation-first mindset
Comfortable building and maintaining automation using scripting or coding languages such as Python, TypeScript, or similar, with familiarity working in Git-based development workflows
Experience building API-based integrations (REST APIs, webhooks, and event-driven workflows) across SaaS tools
Hands-on-experience with IAM platforms (Okta or similar)  and automation tools (Okta Workflows, Tines, etc.)
Strong experience administering SaaS environments (Google Workspace, Slack, Zoom) and debugging complex, cross-system issues
Solid foundation in networking, security, and infrastructure-as-code (e.g. Terraform), with a bias toward systems built and managed through code
Experience in high-growth or startup environments
Experience operating in environments where IT is treated as an engineering discipline rather than purely operational support
Comfortable with AI coding tools (Claude Code, Codex, or similar)

WHO WE ARE:

We move fast, raise standards, and own outcomes. We hire drivers, not passengers – people who take initiative, solve problems, and sweat the details because lives depend on it. Momentum matters in healthcare where slow decisions cost lives. At Cadence, we set a high bar and back each other relentlessly to clear it. If you’re ready to do the best work of your career and make a real impact in healthcare, join us.

WHAT YOU’LL GET:

Autonomy to tackle big, complex problems that matter
An opportunity to improve lives every single day
A chance to shape a category‑defining company at scale
Medical, dental, and vision insurance
Competitive total compensation and meaningful equity
National and local discounts powered by TriNet
Unlimited PTO and paid holidays
Remote equipment setup and home office stipend
Paid Parental Leave
401K and 401K match
Charitable Donation Match program
Location: Remote

Noteworthy

Our job titles may span more than one career level. The base pay for this role typically ranges between $190,000 – $230,000 annual base salary. The actual base pay is determined by a variety of factors, including experience, skills, training, and business needs. Compensation may vary based on market location and is subject to change.

Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws. 

A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team.  Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.

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