Staff IT Systems Engineer

About Cadence

Sixty million Medicare seniors live with chronic disease. The care system sees most of them twice a year. Cadence is building the infrastructure to support them every day.

Cadence is a clinical AI company that delivers continuous, proactive care for older adults with chronic conditions like hypertension, heart failure, and diabetes. We pair patients with a dedicated clinical team, integrate deeply into health system EMRs and workflows, and use our Clinical Intelligence platform to monitor vitals, surface risk early, optimize medications, and close care gaps between visits. The result: patients engage with care 100x more than before Cadence, clinicians focus on judgment instead of administrative work, and Medicare saves $2M a week.

We operate as a full clinical care delivery organization, not a software vendor. Our clinicians work alongside health system partners, extending the reach of local primary care providers into patients' homes. We're now applying AI agents across these workflows – from alert review and medication titration to lifestyle coaching and care coordination – with clinicians always in control of clinical decisions.

The Role

We're hiring a Staff IT Systems Engineer to 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. This person will drive platform maturity through API integrations, identity lifecycle automation, and code-driven workflows to ensure our teams operate securely and at peak efficiency, while raising the technical bar of the IT organization through mentorship, standards, and scalable systems design.

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 with IT, Security, and business teams to design scalable solutions and improve core systems.
• Establish technical standards, operational rigor, and engineering best practices across the IT organization, and mentor team members on automation, infrastructure-as-code, integrations, and scalable systems design.

What You Need

• 8+ years of experience in IT systems engineering or a related field.