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