Head of Engineering - AI-Native Healthcare SaaS | Zenara Health

Job Description

Head of Engineering — AI-Native Healthcare SaaS | Zenara Health

Role Title: Head of Engineering

Location: Remote across India (4-8 hours overlap with US Pacific time)

Type: Full-time

Reports to: Founder-CEO

Compensation: ₹40–60 LPA + equity (based on ownership potential, not merely past performance)

About the Company

Zenara Health is a technology-oriented mental healthcare organization focused on enhancing accessibility and quality of mental wellness services. We integrate AI-driven platforms with professional clinical care to offer personalized and effective mental health solutions, fostering a seamless digital experience for both patients and providers. Our rapid development includes various products throughout the clinical workflow, from AI-enhanced evaluations to care coordination. We are a startup, not merely a department.

About the Role

Pay close attention here. If you are an engineering manager who primarily conducts standups and writes status reports, this role may not suit you.

We are in the transition from the product stage to the commercial stage, servicing multiple products with real customers and clinical data. Our exceptionally skilled engineers are already delivering across various products, and now we seek cohesive engineering leadership to transform exceptional individual contributions into collective organizational success. You will take ownership of everything: delivery, personnel, architecture, release engineering, security measures, and recruiting.

This position is not for a "Director of Engineering" at a firm with 200 engineers and a CTO above you. This role designates you as the core of engineering leadership. You will report directly to the founder-CEO, assume responsibility for results, and shape the organization.

We are looking for an individual who has managed engineering teams of 5-20+ members, successfully shipped SaaS products under tight deadlines, and possesses the intuition to provide unified direction when top engineers require it. You have proven this capability in the past and are eager to build from the ground up. We offer significant compensation above the norm for Indian startups in this position because we’re not hiring a project manager sporting an engineering title; we are seeking someone to be the technical co-leader to a founding CEO — ultimately becoming someone the founder can rely on to oversee engineering matters.

What You Will Own (Everything)

1. Delivery Outcomes

You will oversee delivery for all products, including scope management, release schedule, quality controls, and alignment with stakeholders. If something is delayed, it will be your responsibility. Conversely, if a product ships smoothly and on time, you can claim that success. You'll shield engineers from scope changes and provide the CEO with predictable delivery rather than relying on last-minute salvaging.

2. Engineering Team

You will directly manage the engineering team, handling hiring, performance assessments, coaching, providing feedback, conflict resolution, and talent retention. You will cultivate the team's culture and set the performance standards. Difficult conversations will happen early rather than allowing issues to linger. Engineers will want to work with you not because you are lenient, but because you are fair, straightforward, and dedicated to their professional development.

3. System Architecture

You will have responsibility for the system architecture across the complete stack: web applications, APIs, infrastructure, and AI integrations. You will make critical trade-off decisions on when to prioritize speed over thoroughness, when to refactor versus ship, and when to invest in infrastructure as opposed to features. You should be capable of delving deep enough to review code, troubleshoot production issues, and question architectural approaches with substantiation.

4. CI/CD and Release Engineering

You will establish the release pipeline, including CI/CD practices, environment setups, quality checkpoints, and deployment automation. You will eliminate disorganized releases and create a system that enables the team to ship confidently and regularly.

5. Security Posture

You will be responsible for engineering security measures, including access control, secrets management, audit trails, and SDLC security protocols. Given the sensitivity of healthcare data, these are imperative. You will enforce these measures without succumbing to bureaucratic red tape.

6. AI Governance

As an AI-driven organization, our engineers utilize AI tools daily. You will define the policies regarding which tools are approved, how intellectual property is safeguarded, and ensure AI accelerates development while mitigating risks. You will facilitate speed while preventing vulnerabilities. If you lack a well-defined perspective on AI governance in engineering, you are not suited for this position.

7. Hiring

You will construct the engineering team, delineate roles, maintain hiring standards, conduct technical interviews, and make decisions on hires. You will be responsible for developing the engineering organization that will enable the company to scale beyond its startup phase.

Your First 90 Days

Week 1-2: Immerse yourself. Meet with each engineer. Understand every product, deployment, and pain point. Identify delivery risks and the most significant bottleneck. Build trust through active listening rather than announcing changes.

Month 1: Establish a regular delivery schedule. Define the release process and quality standards. Create routine communication patterns for engineering (standups, retrospectives, planning sessions). Begin surfacing risks early and reliably, relieving the CEO from delivery ownership.

Month 2-3: Standardize CI/CD practices across all products. Implement an AI governance framework. Initiate architecture assessment — not a complete rewrite, but a clear development roadmap. Start bridging gaps in hiring. Develop the engineering runbook: our building practices, shipping processes, and incident response strategies. Cultivate feedback and coaching routines that foster continual improvement for the team.

Ongoing: Take ownership of engineering matters. Monitor reliable shipping. Grow the team. Raise performance expectations. Instill confidence in the CEO that engineering is in effective hands.

Values & Vibe (Who You Are)

You view engineering leadership as primarily about outcome ownership rather than task management. You are the person who steps into a chaotic delivery environment and establishes order — not through an overabundance of processes, but via clarity, accountability, and effective communication. Your experience resides in startups, not just large enterprises. You find an engineering environment that operates like a black box, characterized by heroic releases instead of standard practices unacceptable. You interact well and directly with individuals, providing feedback that leads to the development of engineers. You engage in difficult discussions and do not shy away from conflict, managing it promptly and effectively. Your teams trust you due to your honesty, consistency, and dedication to maintaining their focus.

You are proactive enough to review code, resolve issues, and evaluate architecture — yet understand your main responsibility lies in making your team effective, rather than being hands-on with coding. You integrate AI tools into your engineering processes and have insights into how engineering teams can utilize AI safely and productively. You have contemplated matters concerning intellectual property protection, authorized tools, and developer experience — extending beyond the simplistic approach of "we use Copilot." You have successfully launched real products that serve actual users within specified deadlines. You understand the difference between building something and successfully delivering it.

What Success Looks Like

• Engineering consistently delivers results — the CEO no longer needs to chase down updates on delivery.
• The release schedule is established and continually improving; quality standards are adhered to.
• Engineers have clear responsibilities, receive coaching, and consistent feedback — expectations are unambiguous.
• Architectural decisions are documented and thoughtfully reasoned — not arbitrary.
• The security posture is robust, including access controls, audit trails, and enforced AI governance.
• The recruitment pipeline is dynamic — you are actively building the team while also managing the current group.
• AI tools are utilized within a clear governance framework — promoting speed without added risk.
• You seamlessly switch between various products without compromising performance.
• The engineering organization is healthier, faster, and more dependable than it was upon your arrival.

Requirements

Requirements

Required

• 10-18 years in software engineering, including a minimum of 4 years in engineering management, overseeing delivery, managing personnel, and making architectural decisions (beyond just having the title of "team lead").
• Managed teams of 5-20+ engineers - direct oversight, recruitment, performance evaluations, mentorship, and, when necessary, termination.
• System architecture - Designed and advanced SaaS systems. Capable of reasoning across front-end, back-end, database, and infrastructure components. Has made significant trade-off decisions while working within real constraints.
• CI/CD and release engineering - Created or significantly enhanced release pipelines, quality gates, and environment management. Understands what it means to "ship confidently".
• Cloud infrastructure (Azure or AWS) - Managed production systems. Possesses knowledge of security, reliability, and cost trade-offs.
• Full-stack technical depth - While not in an IC role, is hands-on enough to review code, debug production issues, and question engineers on design choices. Developers value your technical insights.
• Security fundamentals - Proficient in access control, secrets management, audit trails, and basic SDLC security. These are essential in healthcare.
• Strong English communication skills - Async-first, produces clear written decision memos, engineering plans, and risk escalations. You document decisions as well as make them.
• Startup or high-growth experience - You have successfully delivered in environments characterized by ambiguity, limited resources, and urgent timelines. Backgrounds solely in enterprise settings may find it challenging here.

Strongly Preferred

• Experience in healthcare SaaS (EHR, billing, clinical workflows, HIPAA).
• Familiarity with the TypeScript/Node/React ecosystem.
• Understanding of observability and SRE practices (logging, metrics, tracing, incident response).
• Experience with AI/ML productization — delivering AI features safely in production.
• Experience in building QA/test automation into the engineering culture.
• Familiarity with EOS (Entrepreneurial Operating System) or similar operating frameworks.
• Leadership of remote-first teams across multiple time zones.

Nice to Have

• Knowledge of FHIR/HL7 healthcare data standards.
• Experience with Kubernetes or container orchestration.
• Familiarity with SOC 2 or similar compliance frameworks.
• Experience in B2B multi-tenant SaaS environments.
• Exposure to mental health or behavioral health domains.
• Familiarity with FDA AI/ML compliance requirements.

Schedule

Evening IST hours with 4–8 hours of daily overlap with US Pacific (9am–5pm PT). You can suggest the schedule that suits you best — our focus is on overlap and team availability rather than strict clock-in times. Leadership availability is expected during critical releases or incidents.

Benefits

Benefits

• Salary range of ₹40–60 LPA, depending on skills and responsibilities
• Equity participation (ESOP) — as you contribute to building the engineering organization, you will have ownership of a part of it
• Fully remote work opportunities available across India
• Equipment allowance provided
• Comprehensive health insurance
• Culturally recognized local holidays (India)
• Flexible paid time off
• Budget for leadership development and coaching
• Direct and regular communication with the founder-CEO — you will have direct access without intermediaries
• The opportunity to establish an engineering organization from scratch