Why we are hiring
Bolting AI onto an existing EHR is like strapping a rocket engine onto a horse-drawn carriage. We build entirely new EHRs with AI woven into their foundations and developed in an AI-driven way: Sakigake Prime for acute and recovery care, and Sakigake Rita for psychiatric hospitals.
With orders growing, led by psychiatric and rehabilitation hospitals, we have entered the phase of scaling deployments. We are looking for core engineers to strengthen a small, AI-driven team that ships a hospital's core system while meeting the requirements of Japan's standard EHR and the security guidelines for medical information systems.
What you will do
You will design and implement the EHR that runs an entire hospital — orders, records, nursing, documents, billing and claims. Working directly with physicians, nurses and customer success, you will translate needs into design and, in a development process built around AI coding agents, ship working software to the front line quickly and refine it there.
Core EHR feature development
- Design and implementation of core hospital functions: orders, clinical and nursing records, documents, billing and claims
- Feature design tailored to the workflows of psychiatric, recovery and acute-care settings
- Refining requirements in dialogue with physicians, nurses and customer success, and continuously improving based on frontline feedback
Generative-AI features
- Designing and building AI features such as automatic drafting of discharge summaries, referral letters and certificates, structured input from voice, and clinical decision support (CDSS)
- Evaluation design to guarantee the accuracy and safety of AI-generated medical documents, plus prompt and workflow improvement
Healthcare standards and integrations
- Support for healthcare interoperability standards such as HL7 FHIR and SS-MIX2
- Integration with external systems: online eligibility verification, electronic prescriptions, laboratory and medical devices, and billing systems
Quality, security and cloud infrastructure
- Security design and operations compliant with Japan's guidelines for medical information systems (the "three-ministry, two-guideline" framework)
- Designing and operating cloud infrastructure on AWS, monitoring and backup, and running monthly releases
Driving AI-native development
- Designing and improving a development process, code review and test automation built around AI coding agents
- Continuously raising developer productivity so a small team can ship a hospital's core system
Why this role
Build at the same table as clinicians
Our CEO is a practicing psychiatrist and hospital director, our medical director is an emergency and critical-care physician at a university hospital, requirements are handled by a former nurse, and our engineering manager has more than 20 years of EHR and billing-system development behind him. You design in direct discussion with people who know the front line, not from second-hand reports.
AI-native from the ground up, not bolted on
We are not retrofitting an existing EHR; we are building a new platform designed around AI. Document generation, structured input and other AI features are designed as one with the core, and development itself is AI-driven. You join at the most technically interesting moment in EHR development, as a core member.
Hands-on impact at the frontier of policy and practice
Our CTO, Arimura, was project manager for Japan's standard EHR at the Digital Agency. You will design with national initiatives such as the standard EHR and medical DX in view, and what you build will run entire hospitals. It is work where you can feel your code giving time back to clinical staff.
Requirements
- 3+ years of professional web application development (backend, frontend, or both)
- Experience in data modeling, design and implementation with relational databases
- Experience developing in a team (Git, code review, CI/CD)
- Interest in clinical problems, and the ability to refine specifications in dialogue with non-engineers such as physicians and nurses
Nice to have
- Experience developing EHRs, medical billing systems, or other healthcare information systems
- Knowledge of healthcare standards and integrations such as HL7 FHIR, SS-MIX2, online eligibility verification and electronic prescriptions
- Experience designing and operating on AWS or other clouds, and with Infrastructure as Code
- Experience building products with LLMs (RAG, evaluation design, prompt design) or developing with AI coding agents
- Certification as a healthcare information technologist, or knowledge of Japan's fee-for-service and DPC reimbursement systems
- Work experience in the healthcare domain
Who we are looking for
- Sees AI changing the craft of software development as an opportunity to enjoy, not a threat
- Comfortable shipping working software fast and refining it with feedback from the front line
- Takes ownership of balancing quality and speed in a system that affects patient and clinician safety
- Enjoys the change and uncertainty of a startup and is willing to work beyond a fixed scope
Conditions
- Salary
- JPY 6.0–12.0 million per year (JPY 500,000–1,000,000 per month), determined based on skills, experience and current compensation.
- Location
- Win Kanda Bldg. 4F, 1-7-1 Kanda-Sudacho, Chiyoda-ku, Tokyo 101-0041, Japan (remote work available)
- Employment
- Full-time employee
- Work style
- Flextime (core hours 11:00–15:00)
- Standard working hours: 8 hours per day
- Remote work available
- Smoke-free indoors
- Holidays
- Two days off every week
- Year-end and New Year holidays
- Paid leave (granted from day one)
- Maternity, paternity and childcare leave
- Special leave for family events
- Probation
- 3 months
- Benefits
- Full social insurance (employment, workers' compensation, health, pension)
- Annual health check and flu vaccination
- Business travel allowance