AI Integrations Engineer (Conversational AI In Healthcare)

Location: Remote (U.S.-based only)
Employment Type: Full-time
Compensation: $110,000 – $140,000 base + equity
Citizenship Requirement: U.S. citizens only, onshore 

About Grapefruit Health

Grapefruit Health is a healthcare technology company revolutionizing patient outreach and workforce development. We do this by training and managing clinical students to perform remote, telephonic interactions with patients using our web application. Patients get the care they need, healthcare organizations can do much more, and you get to learn while you earn. It is a win-win-win!

We’re now expanding our platform with conversational AI—integrating advanced voice and text models to automate and enhance patient communications safely and effectively, always with a human in the loop. 

The Role

We’re looking for a mid-level AI Integrations Engineer to lead the implementation and maintenance of our conversational AI systems. You’ll work closely with our engineering and product teams to integrate the large language model (LLM) Gemini 2.5 (Vertex AI) into our existing outbound call center and SMS infrastructure.

Your primary focus will be secure orchestration, PHI-safe prompt design, and robust system monitoring—not full-stack app development.

Key Responsibilities

Integrate LLMs (specifically GCP products like Gemini 2.5, Vertex AI) with our outbound call and text platforms.

Develop middleware that securely handles PHI and supports HIPAA-compliant/HITRUST prompt generation and model interaction.

Implement and maintain guardrails for model behavior, fallback logic, and human handoffs.

Monitor and optimize API usage, latency, and dialogue performance.

Collaborate with our internal team to refine conversational flows, tone, and outcomes based on real-world call data.

Ensure HIPAA compliance across data logging, anonymization, and audit trails.

Support retraining or fine-tuning of models using anonymized transcripts and feedback loops.

Document and maintain technical architecture, testing protocols, and deployment processes.

Qualifications

Required:

• U.S. citizenship and onshore (due to PHI and HIPAA compliance requirements).

• 4+ years of professional software engineering experience, including production AI or ML integration.

• Hands-on experience with Vertex AI, Google Cloud Platform (GCP).

• Proficiency with Python or Node.js, and modern REST or GraphQL API design.

• Solid understanding of data security, encryption, and HIPAA-compliant architectures.

• Experience deploying, monitoring, and scaling cloud-based systems, specifically AWS and GCP.

• Strong communication skills and ability to collaborate cross-functionally.

• Familiar with AWS S3 buckets, building data pipelines, and BI tools such as Looker

• Experience with prompt engineering and conversational UX + guardrail iteration

• Strong in sql, postgresql, basic networking (VPC) and data debugging skills

• Must be able to hit the ground running - we expect some onboarding time, but in general you should have the experience to start building in week one with minimal handholding. 

Preferred:

• Prior work with contact center systems (e.g., Twilio, Five9, Amazon Connect, NICE, etc.).

• Familiarity with healthcare data formats (FHIR, HL7, EHR/CRM integration).

• Background in healthcare, digital health, or patient engagement technology.

What We Offer

• Competitive salary ($100K–$150K) + meaningful equity package. Actual salary will be determined by level of experience

• Health/Dental benefits for employee plus family members

• Generous 401k

• Remote-first work environment.

• Opportunity to lead next-generation conversational AI in healthcare.

• Small, fast-moving team where your work has direct impact.

• Mission-driven culture focused on improving patient lives and empowering healthcare workers.