Full-Time

Lead Engineer

Backend

Onos Health

Onos Health

11-50 employees

Provider quality platform reducing costs

Compensation Overview

$200k - $275k/yr

+ Equity

San Francisco, CA, USA

Hybrid

Two to three days per week in the San Francisco office required.

Category
Software Engineering (1)
Required Skills
LLM
Python
GitHub Actions
Git
Machine Learning
Postgres
ClickHouse
Docker
TypeScript
AWS
JIRA
Terraform
Next.js
Celery
Django

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Requirements
  • At least 5 years of experience building software applications.
  • Prior experience leading engineering teams as a technical lead or engineering manager.
  • Strong product sense and system design skills, including defining clear requirements, test scenarios, and acceptance criteria for complex systems.
  • A hands-on technical leadership background capable of architecting robust and extensible systems, establishing best practices with AI coding tools, and shipping high-quality production code.
Responsibilities
  • Architect workflows that use artificial intelligence and machine learning to process claims, medical records, and other data types to evaluate the optimal care path for health plan members.
  • Lead the integration and rollout of the Onos platform for new enterprise customers to provide actionable insights and recommendations to health plan administrators.
  • Own end-to-end development of new platform features and functionality, including requirements gathering, scoping, architecture, implementation, and testing.
  • Establish engineering best practices and technical foundations for future team growth.
  • Shape the technical roadmap, make key architectural decisions, and influence the company's product and technical strategy.
  • Develop an intelligent engine that ingests medical standards-of-care documents and evaluates provider adherence to guidelines.
  • Design and implement robust and extensible systems that support different enterprise workflows and integrations.
  • Build artificial intelligence and machine learning pipelines to analyze handwritten clinical notes, extract important medical information, and automate recommendations for clinical reviewers.
  • Scale systems to process millions of healthcare records while maintaining strict security and compliance requirements.
Desired Qualifications
  • Experience working with machine learning and large language models for end-user applications.
  • Hands-on experience navigating healthcare data formats such as EDI X12, HL7, FHIR, and custom payer flat files.

Onos Health builds a configurable platform for health plans to measure provider quality and reduce waste. It analyzes large volumes of unstructured data and clinical notes to determine how well providers deliver care and where improvements are needed, helping plans improve member outcomes and lower costs. The platform integrates with existing systems and runs machine learning and AI models locally, keeping data private and compliant with HIPAA. This approach differs from many competitors by prioritizing locally hosted AI, strong data security, and practical actions that address inefficiencies in the care process. The goal is to help health plans improve care quality while cutting the roughly $200 billion lost annually to unnecessary or abusive provider practices.

Company Size

11-50

Company Stage

Seed

Total Funding

$6.3M

Headquarters

San Francisco, California

Founded

N/A

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Simplify Jobs

Simplify's Take

What believers are saying

  • Onos raised $6.3 million in October 2025 from Haystack and Pathlight.
  • Its website says it works with the nation's largest health plans.
  • Open roles for integrations, AI, and clinical review signal active customer rollout.

What critics are saying

  • Onos still depends on winning a few large health plans before 2027.
  • Behavioral-health workflow customization slows deployment across fragmented payer policies.
  • If rivals bundle similar utilization management into existing stacks, Onos becomes replaceable.

What makes Onos Health unique

  • Onos is purpose-built for behavioral health, not generic payer analytics.
  • Its model ingests claims, notes, eligibility, and policies into one workflow.
  • Locally hosted AI and HIPAA-compliant infrastructure target privacy-sensitive health plans.

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Benefits

Unlimited Paid Time Off

Paid Parental Leave

Health Insurance

Dental Insurance

Vision Insurance

Pre-tax Commuter Benefits

401(k)

Company Equity

Remote Work Options

Hybrid Work Options

Stock Options

Ground-floor opportunity to help build a team and culture

Regular team events and offsites

Personal equipment and home office setup

Unlimited vacation policy

Paid parental leave

Medical, dental, and vision insurance

Pre-tax commuter benefits

401(k)

Significant equity as an early employee

Direct mentorship from experienced founders

Ground-floor opportunity to help build a team and culture

Regular team events and offsites

Company-provided equipment and home office setup

Growth & Insights and Company News

Headcount

6 month growth

-9%

1 year growth

-9%

2 year growth

-9%
Fenoms Talent
Oct 16th, 2025
Onos Health Raises $6M to Build the Decision Backbone for Behavioral Health

Onos Health raises $6M to Build the decision backbone for behavioral health. Onos Health, a data-driven startup redefining how payers manage behavioral health, has raised $6 million in fresh funding from Haystack, Pathlight Ventures, Bertelsmann Investments, and Nebular. Founded by Akshay Agrawal, the company is on a mission to eliminate waste, friction, and bias from the behavioral healthcare system - where payers, providers, and patients often operate on different timelines, disconnected systems, and inconsistent definitions of "quality." With this new round, Onos aims to become the AI-powered operating layer for behavioral health decisions, helping insurers and networks align care pathways with data, not guesswork. Where behavioral health is breaking down. In the U.S., behavioral health remains one of the most administratively burdensome areas in medicine. Health plans face rising claims volume, unclear outcome metrics, and inconsistent provider documentation - all while demand for therapy and psychiatric care surges. Studies show that one in four Americans now seeks behavioral care, yet most health plans still rely on manual review systems designed for physical medicine. Onos estimates that over $60 billion annually is lost in inefficiencies - denials, misaligned care, and redundant reviews. Those losses don't just reflect poor management; they represent slow decision cycles. A claim delayed by 10 days doesn't just cost time - it risks treatment dropout, worsened outcomes, and higher downstream costs. That's the operational hole Onos is closing. Inside the platform. The company's product ingests behavioral health claims, clinical notes, and utilization data, then applies machine learning to identify patterns of overuse, underuse, or misaligned interventions. Its system generates real-time decision support that mirrors human clinical judgment - automating low-risk approvals and flagging edge cases for human review. By aligning payers' policies with evidence-based standards, Onos shortens cycles from days to minutes while maintaining clinical oversight. So far, early pilots with regional health plans have shown up to 60% faster authorizations and 30% higher adherence to standardized care pathways - a shift that could redefine payer-provider collaboration. The hidden advantage: owning the interface between insight and action. What makes Onos different isn't just its AI models - it's where those models live. Most healthcare AI tools sit upstream, generating predictions about cost, risk, or outcomes. But those insights often die in dashboards, never reaching the workflows where decisions are actually made. Onos, by contrast, embeds itself inside the decision layer - the exact interface where human reviewers, policy logic, and patient outcomes collide. This may sound subtle, but it's where durable companies are born. In complex industries like healthcare, the deepest moats form not around prediction, but around execution dependency. If your system becomes the layer through which every decision flows - and improves with every cycle - you evolve from a product into infrastructure. That's the shift Onos is quietly executing. For founders, there's an unspoken lesson here: own the bottleneck others take for granted. Don't just optimize visibility; automate the action. In B2B systems, the biggest arbitrage lies between "knowing" and "doing." Whoever controls that handoff controls the system. That's the power of what Onos is building. It's not just teaching machines to predict - it's teaching institutions to decide better, faster, and with less bias. Market context: A system under pressure. The timing couldn't be sharper. The global behavioral health market - encompassing therapy, psychiatry, substance use, and digital interventions - is projected to surpass $800 billion by 2030, growing at ~5 - 7% CAGR. Meanwhile, health payers are increasingly under regulatory pressure to prove mental health parity - ensuring behavioral benefits are managed with the same rigor as physical health. AI-driven utilization management platforms are emerging as critical infrastructure for compliance and efficiency. Analysts estimate that AI adoption in healthcare administration could reduce costs by up to $150 billion annually by 2027 (McKinsey). Behavioral health, with its high variability and documentation complexity, is arguably the segment most ripe for impact - and least transformed so far. Use of funds & growth path. According to the company, the $6M seed funding will be used to: * Expand Onos' AI and data science teams to refine behavioral health-specific models * Deepen integrations with health plan systems (claims, provider networks, EHRs) * Strengthen explainability and trust features for regulatory compliance * Scale partnerships with regional and national insurers * Build feedback systems that adapt to local plan policies and reviewer decisions Founder Akshay Agrawal, who previously worked in product leadership across healthcare and AI, emphasizes that behavioral health data presents unique modeling challenges - "noisy, subjective, and inconsistent." The company's core innovation lies in turning those inconsistencies into patterns that systems can learn from safely. A broader industry signal. Onos' raise reflects a broader pattern: a new generation of startups building "decision infrastructure" - not just analytics or automation tools. It's part of a wave that includes healthtech players in claims optimization, clinical coding, and AI-assisted care routing. These startups share one thesis: the future of healthcare isn't just more data - it's better data actionability. That shift is resonating with investors. Venture funding in digital health analytics and payer-facing AI tools has grown 230% since 2020, with behavioral health tech seeing one of the steepest climbs (CB Insights). The reason is structural: unlike consumer wellness apps, payer AI tools directly tie to bottom-line ROI - lower medical loss ratios, fewer denials, and measurable quality-of-care metrics. Risks & What to watch. * Data fragmentation: Behavioral health data comes from disparate sources (claims, EMRs, notes) - normalization is key. * Trust barriers: Payers need explainable, audit-ready AI to avoid regulatory pushback. * Adoption inertia: Human reviewers and clinical teams may resist automation without robust oversight features. * Policy variation: Each payer's rules differ; scalable customization remains complex. Despite these, Onos' strategy - embedding within decision systems rather than standing beside them - gives it a unique growth path. Every decision made through Onos trains its models, compounding precision and defensibility over time. Growth & scaling insights. Latest additions.

Business Wire
Oct 15th, 2025
Onos Health Raises $6M to Transform How Health Plans Manage Behavioral Health

Onos Health, a healthcare AI company focused on transforming how health plans manage behavioral health, today announced $6.3 million in an oversubscribed ven...

IT桔子
Oct 13th, 2025
Onos Health Secures $6.3M Seed Funding

Onos Health, an AI healthcare company, has secured $6.3 million in seed funding from Haystack Ventures.

FinSMEs
Oct 9th, 2025
Onos Health Raises $6M in Funding

Onos Health, a San Francisco, CA-based healthcare AI company supporting how health plans manage behavioral health, raised $6M in funding.