IT & Automation Engineer

About Us: Here at Ambience, we never set out to be just another scribe. We’re building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country. Our technology helps providers focus on delivering great care by removing the administrative burden that pulls them away from patients and away from their most impactful work. Ambience delivers real-time coding-aware documentation and clinical workflow support across ambulatory, emergency and inpatient settings at the top health systems in North America. Our teams operate relentlessly with extreme ownership to build the best solutions for our health system partners. We value candor, positivity and deep thought — and we expect a lot from each other because we know the problems we’re solving truly matter. Ambience was ranked #1 for Improving the Clinician Experience in the KLAS Research Emerging Solutions Top 20 Report, recognized by Fast Company as one of the Next Big Things in Tech, named one of the best AI companies in healthcare by Inc., and selected as a LinkedIn Top Startup in 2024 and 2025. We’re backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, and Kleiner Perkins — and we’re just getting started. THE ROLE: Ambience is scaling fast, and our internal systems need to keep up — securely, automatically, and without slowing anyone down. You’ll be our first dedicated IT Engineer, owning identity, devices, endpoints, and SaaS access across the company. This is not a ticket-queue role. You’ll build the automation and infrastructure that makes IT disappear for employees while raising the security bar across the board. You’ll design identity and device systems that scale with headcount, enforce least-privilege by default, and turn manual IT work into code. The goal: secure, compliant internal systems that people don’t think about — because they just work. Our roles are hybrid in our SF office (3x/week). WHAT YOU’LL OWN: Identity & Access Automation — Build Okta joiner/mover/leaver workflows with role-based access, automated provisioning, and clean offboarding. Kill standing access and manual tickets. Device Management & Endpoint Security — Run Jamf and Intune in a mixed Mac/Windows environment. Zero-touch provisioning, compliance baselines, patching, and end-to-end Zero Trust. AI-Forward Operations — Improve the customer and employee experience through AI-driven ticketing, intelligent bots, and automated workflows that reduce resolution time and cut manual toil. Infrastructure as Code — Move IT configs out of admin consoles into Terraform and GitOps. Version-controlled, peer-reviewed, reproducible changes across identity, MDM, and workspace systems. SaaS Governance — SaaS inventory: Provisioning, tools, access, cost, and security reviews and posture. Surface shadow IT, consolidate sprawl, and run access reviews. WHO YOU ARE: 7+ years building IT and/or corporate security systems at a startup or high-growth company Deep Okta experience beyond admin work — you’ve deployed advanced identity programs Strong hands-on Jamf and Intune experience in Mac/Windows environments Automation-first: Terraform, APIs, scripting (Python, Bash, PowerShell), Workflow automation Comfortable operating across security, IT, and engineering boundaries Technology person at heart with a passion for the space and does not just see IT as a job In SF, 3x/week in-person WHY HERE: At Ambience, IT is foundational. The systems you build determine how safely we operate, how fast teams move, and how confidently we scale inside regulated healthcare environments. You’ll own this function end-to-end at a critical growth moment, with real autonomy, direct access to leadership, and the mandate to replace chaos with clean, automated systems. Small team, high trust, real impact. Pay Transparency We offer a base compensation range of approximately $200,000–$225,000 per year, along with meaningful equity. This intentionally broad range provides flexibility for candidates to tailor their cash and equity mix based on individual preferences. Our compensation philosophy prioritizes meaningful equity grants, enabling team members to share directly in the impact they help create. If your expectations fall outside of this range, we still encourage you to apply—our approach to compensation considers a range of factors to ensure alignment with each candidate's unique needs and preferences. Life at Ambience Working at Ambience means opting into a high-ownership, high-trust environment built for people who want to grow fast, operate decisively and focus on work that matters. This could be the right place for you if you want to - Work on mission-critical AI technology that directly improves clinicians’ day-to-day lives and health system financial health across some of the most complex, high-stakes workflows in the world. - Join a “dream team” culture where we hire exceptional people, expect exceptional outcomes and invest deeply in feedback and continuous growth. We operate as a championship team, and that means being ok with hard, uncomfortable, ambiguous problems that lead to real greatness. - Operate with real ownership and accountability in an environment where there are no bystanders: If something is broken, we fix it! You will have meaningful autonomy and be expected to drive work to completion. To help you do your best work, we pair these expectations with benefits intentionally designed to help you feel supported and safe at Ambience and beyond. Some of our key benefits include - Comprehensive medical, dental, and vision coverage for you and your dependents - 401(k) with a company match of up to 3% of base salary - A remote-friendly culture (with a San Francisco HQ) and full equipment provisioning to ensure you can work effectively from wherever you’re based. - Parental leave to support your family needs - Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings, with travel, lodging and meals covered - Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24–January 1 designed to support real rest and long-term sustainability. Ambience Healthcare is an equal opportunity employer and is committed to building a diverse and inclusive workplace. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, genetic information, or any other legally protected status. We encourage applicants from all backgrounds to apply. Ambience is committed to supporting every candidate’s ability to fully participate in our hiring process. If you need any accommodations during your application or interviews, please reach out to our Recruiting team at accommodations@ambiencehealthcare.com recruiting@ambiencehealth.com. We’ll handle your request confidentially and work with you to ensure an accessible and equitable experience for all candidates. Ambience Healthcare has become aware of scams targeting jobseekers with fake jobs and even interviewing people. Our emails will always come from @ambiencehealthcare.com. We would never our ask candidates to download apps or make any form of payment(s). If you are contacted through WhatsApp, Telegram, similar but fake email domains, or asked to make a payment, these contacts are not legitimate. Report the issue immediately to LinkedIn and the FBI https://www.fbi.gov/how-we-can-help-you/scams-and-safety.