Senior IT Systems Engineer

Cadence is the clinical AI company automating the treatment of chronic disease. Its Clinical Intelligence takes on the routine, high-volume work of chronic care – monitoring patients, surfacing risks, and coordinating action – so clinicians can focus on the decisions that require them. Grounded in partnerships with more than 20 leading health systems, deep EMR integrations, dedicated medical group, and experience serving a population of more than 100,000 patients, the system learns from real-world care delivery, improving as it scales. Cadence has been recognized by TIME as one of the Top 100 HealthTech Companies and by LinkedIn as a Top Startup (#4, 2025). The Role We're hiring a Senior IT Systems Engineer to design, automate, and scale the core infrastructure that powers our company. This is an engineering discipline role where the expectation is code driven systems, not ticket driven operations. This person will contribute to platform maturity through API integrations, identity lifecycle automation, and scalable workflow design with a direct impact on how Cadence's clinical and operational teams function every day. What You'll Do Design, build, and own automation across core IT systems to reduce manual work, improve reliability, and scale with the organization. Develop API-driven integrations and event-based workflows across platforms including Okta, Google Workspace, Slack, and other critical SaaS tools. Build and scale identity lifecycle automation covering joiner, mover, and leaver workflows with a strong focus on security and operational efficiency. Contribute to root cause resolution for recurring technical issues, eliminating failure points through system design and automation rather than repeated manual intervention. Strengthen the technical quality of IT systems through rigorous code review, thorough documentation, and repeatable automation patterns. Serve as the escalation point for complex cross system issues, debugging across integrations, environments