VP Engineering, CTO Track | Pediatric Therapy SaaS | Remote US

VP Engineering, CTO Track | Pediatric Therapy SaaS | Remote US Every day, pediatric physical, occupational, and speech therapists change children’s lives—but their legacy software makes the job harder than it should be. Join a profitable, PE-backed healthcare SaaS company at the inflection point: we have passionate customers, strong cash flow, and a mandate to rebuild the tech stack for the next decade. As our first full-time VP of Engineering with a clear path to CTO, you’ll lead that transformation end-to-end—shipping modern .NET services, an accessible React front-end, HIPAA-grade cloud infrastructure, and AI-powered clinical features that free clinicians to focus on kids, not clicks. Opportunity Lead the ground-up modernization of a mission-critical EHR and billing platform used by pediatric therapy practices nationwide. Own the multi-year technology vision while remaining hands-on—perfect for a director-level leader ready for the top seat. Work directly with a product-savvy CEO and seasoned designer; inherit two eager engineers who know the codebase cold and are hungry for mentorship. Shape engineering culture, hiring roadmap, and best practices from Day 1 in a high-trust, low-bureaucracy environment. Build HIPAA-compliant AI features (ambient documentation, treatment-plan recommendations, predictive scheduling) that clinicians will love—and competitors will chase. What You Will Own Technology Strategy & Roadmap Define and socialize a phased modernization plan aligned to product, clinical, and business goals. Advise CEO and Board on architecture, AI adoption, and cloud investments. Modernization & New Product Delivery Upgrade the legacy .NET monolith to modern .NET 8/9+ and introduce cloud-native patterns without disrupting active clinical workflows. Replace embedded Bootstrap pages with a WCAG 2.1 AA-compliant React (or Vue/Angular) front-end and launch companion mobile apps. Decompose services and move toward multi-tenant architecture as scale demands. Security, Compliance & DevOps Own HIPAA Security Rule posture, drive SOC 2 Type II readiness, and instill a security-first culture. Stand-up CI/CD, IaC, observability, and disaster-recovery pipelines in AWS/Azure/GCP with support from an MSP. Data & AI Platform Architect a data lake/warehouse integrating clinical, billing, and ops data; enable self-serve BI and ML pipelines. Deliver clinician-facing AI features and developer AI tooling while meeting privacy and safety standards. Team Leadership & External Representation Mentor and grow the existing engineers into a high-performing squad; recruit additional talent as needed. Represent technology with enterprise customers, partners, and auditors. What Makes You a Strong Fit 8+ years of software engineering experience, including 4+ years leading teams as Director, Sr. Manager, or equivalent. Hands-on mastery of the Microsoft .NET ecosystem and a successful track record modernizing legacy .NET systems. Proven experience architecting and shipping large-scale JavaScript/TypeScript front-ends (React, Vue, or Angular). Deep familiarity with HIPAA-regulated environments and healthcare data standards (HL7 FHIR, X12, etc.). Cloud and DevOps depth with AWS, Azure, or GCP—IaC, containers, CI/CD, monitoring. Demonstrated success delivering AI/ML capabilities in production SaaS products. Player/coach leadership style: you still code, review PRs, and set architectural guardrails while empowering others. Excellent collaboration skills across product, design, clinical, and commercial teams. Nice to Have Experience with pediatric therapy, EHR/EMR, or revenue-cycle software. Ownership of SOC 2 Type II audits, ambient clinical NLP, or PE-backed scale-ups. Location & Travel Remote within the United States. Ability to spend significant time in Orlando during the first 6–12 months, then ~20 % travel to Orlando and/or Philadelphia thereafter. Apply now and get a response within 24 hours. Salary: $200,000 – $250,000 / year Originally posted on Himalayas