Senior Engineering Manager, AI Accounting & Ledger Systems
Commure· Healthcare IT· Oct 16, 2026 · 11d ago
Mountain View, CA / Los Angeles, CA / San Francisco, CA
Hybrid
Full-time
Manager
$240K–$275K
5+ years exp
Job description
At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs.
Healthcare carries a $1 trillion administrative burden and we're at the center of transforming it. Today, 500,000+ clinicians across 500+ healthcare organizations nationwide trust Commure to handle $25B+ in annual claims and support over 200 million patient interactions. Our latest $70M raise at a $7B valuation reflects the confidence the market has placed in this mission. We've also been named to the Fortune Future 50 list and the 2026 AI Breakthrough Awards for “Overall NLP Company of the Year.”
Our team works directly alongside clinicians, not through layers of process, which means the gap between what you build and its impact on patient care is immediate. We move fast, deploy daily, and take full ownership from early thinking to production. If you're energized by hard problems, high stakes, and a team that holds itself to a high bar, you'll find your people here.
The future of healthcare is being built right now. Come deliver this transformation.
About the Role
We're hiring a Senior Engineering Manager for the team that owns the financial core of our revenue cycle product. That's three things: the ledger that records every financial event, the reports that billing managers and CFOs close their books on, and the analytics that tell a practice how it's doing.
You'll manage 6 to 8 engineers, from early-career to Senior Staff, own the roadmap with your product partner, and be accountable for financial correctness across the platform. We're partway through rebuilding this surface: moving a decade of report logic onto a drift-free ledger and a modern OLAP layer, while customers keep closing their books on the old one.
What You'll Do
- Manage and grow a team of 6 to 8 engineers. Hiring, performance, career growth. Build people who can each run a customer escalation, a data migration, or an incident end-to-end without you in the room.
- Set the roadmap with your product partner. The goal is to get from building whatever report a customer asked for to customers building their own reports and closing their books without us involved.
- Own financial correctness. For this team, wrong numbers are a worse failure than a slow page. You'll own the systems that catch silent errors: shadow parity harnesses, cross-report tie-out checks, drift monitoring, and correctness SLOs next to the uptime ones.
- Lead multi-quarter migrations (ledger report migration, OLAP golden views) incrementally, with parity checks at each step, without breaking anyone's close.
- Own the customer relationship at the top of the stack. Sit with comptrollers, CFOs, and RCM directors at our largest sites during month-end. Turn their definition of "correct" into software, and turn recurring escalations into roadmap.
- Run cross-team execution with the payments/posting team, data infrastructure, and ops so upstream changes don't quietly break downstream numbers.
What You Have
- 5+ years managing software engineers, including senior and staff-level ICs. You've grown engineers into leads and staff engineers, and you can name them.
- You've shipped financial, reporting, or data-intensive systems in production where the numbers had to tie. You know how a report can be technically correct and still wrong to the person reading it.
- Backend and data fluency. You can review a query plan, push back on a ledger design, and debug a parity failure yourself. Staff engineers will take you seriously because you engage with the substance.
- You've set direction for a product surface and can say what it should look like in 12 months.
- You're comfortable across the table from a CFO explaining why a number moved.
- Operational discipline: on-call, SLOs, and monitoring for correctness as well as availability.
- You move fast on incomplete information and reset timelines honestly when the work turns out bigger than expected.
NICE TO HAVE
- Healthcare RCM, billing, practice management, or clearinghouse background. Or fintech experience with ledgers, close automation, or reconciliation (BlackLine, FloQast, Numeric, Stripe, Modern Treasury).
- OLAP stores (StarRocks, ClickHouse, Druid) run alongside PostgreSQL.
- Double-entry accounting, append-only ledgers, or audit-trail requirements.
- Leading a platform re-architecture while keeping the existing system shipping.
- Shipping LLM features to production. We run an AI report builder that handles thousands of custom reporting requests.
Please be aware that all official communication from us will come exclusively from email addresses ending in @commure.com commure.com. Any emails from other domains are not affiliated with our organization.
Employees will act in accordance with the organization’s information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. Employees will be required to attest to these requirements upon hire and on an annual basis.
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