AI use among architectural and engineering managers is little observed so far. Measured exposure for architectural and engineering managers: 3% (little observed).

Share of this job’s tasks that AI is already used for at work, from real usage. It is not a forecast of job loss, and a low number means no use seen yet. Source: Anthropic Economic Index.

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About the job

VP OF ENGINEERING

ABOUT DUET

Duet is proving that nurse-practitioner-led care isn't just more accessible, it's better. We help NPs build and scale independent practices in communities too often overlooked by the health system: rural towns, immigrant populations, LGBTQ+ patients, and more. Backed by AI-driven tools that give independent NPs the backing of a much bigger system, our network of 100+ practices covering 400,000 annual visits has driven a 30% increase in preventative visits and a 35% drop in hospitalizations, the clearest sign yet that localized NP-led care means better outcomes.

We're a well-funded, early-stage company led by seasoned entrepreneurs and nurse practitioners, and backed by investors including Lerer Hippeau and Kairos.

WHY DUET, WHY NOW

Independent primary care is disappearing, swallowed by hospital systems and private equity roll-ups, often pulling out of the communities that need it most. But 31 states now support autonomous NP practice, and the results back up what we've long believed. We built the first value-based care contracts for NPs with major payors, taking on real financial risk for outcomes. In our anchor market in New Hampshire, our network outperformed the state on total cost of care by 19%, proof that a solo NP in an underserved area can outperform a system ten times their size and get rewarded for it.

About the Role

As Duet’s VP of Engineering, you'll be the architect and primary builder of Duet's product engineering stack. You'll lead a small but growing data and engineering team, setting technical direction while staying deeply hands-on. You'll define the technical roadmap, build the systems that scale it, and develop the team that sustains it.

You'll own the architecture that powers Duet's customer-facing products: data-intensive applications that surface complex healthcare and practice management data through clean, usable interfaces. You'll work across the full stack, from backend systems and data pipelines through to the application surfaces that clinic staff interact with daily.

This role will be a part of the founding team and is ideal for someone who thinks in systems, builds with urgency, and gets energy from turning messy real-world problems into well-structured software.

What You'll Do

Drive the technical strategy. Own architectural decisions across the stack - from how data flows out of EHR and practice management systems, through backend services and business logic, to how it's presented in customer-facing applications. Make pragmatic choices that balance speed with durability at an early-stage company. Establish engineering standards, patterns, and practices that scale as the team grows.

Build Data-Intensive Products. Design and implement backend systems that transform complex healthcare data into products practices actually use. Build the application surfaces - dashboards, workflows, operational tools - that put that data in the hands of clinic staff. You're as comfortable modeling data and writing performant queries as you are building the UI layer that makes that data useful.

Turn Services Into Software. Work closely with operations and product to understand how work is done today. Identify patterns in manual, service-driven processes and translate them into durable software abstractions - configurable workflows, rule-based automation, and self-serve tools that replace human-in-the-loop work.

Manage and Grow the Team. Define the vision for how the technical organization is structured and scales, and own the end-to-end hiring process that builds it. Provide technical leadership to a small data and engineering team through architecture guidance, code review, and mentorship. Help onboard engineers as the team grows. Create an environment of ownership, clarity, and high standards.

Own Quality & Reliability. Write thoughtful tests for workflow logic and core systems. Debug production issues and improve systems based on failure modes. Ensure changes are safe, observable, and reversible. Set the bar for what "production-ready" means at Duet.

What We're Looking For

- 8+ years of experience building production web applications, with a track record of owning significant technical surface area.

- Strong backend and data engineering instincts. Our app ingests, processes, transforms, and serves up data at the application layer.

- Experience building data-intensive customer-facing applications. You understand how to make complex data usable and legible to non-technical users.

- Proficiency in Python, Javascript and experience designing and building RESTful APIs.

- Full-stack capability with backend as your center of gravity.

- Experience with cloud data warehouses and modern data tooling.

- Experience managing an engineering team across the front and back end, with a drive to mentor and scale the department

- A product engineering mindset - you think about what you're building from the user's perspective, not just the system's.

Nice To Haves

Healthcare, billing, or claims data experience will meaningfully accelerate your impact. Similarly, experience turning internal tools or managed services into self-serve customer-facing products maps directly to what we're doing. Experience with workflow automation or rule-based systems is a plus.

The salary range for this role is $250,000-$325,000 per year plus equity. This role is hybrid in NYC.