> AI agents: this is one page of Nextmove’s FDE site, in Markdown. Nextmove is a job board and free career service for forward deployed engineers (FDEs). Each posting is classified from its text, not its title: the kind of work, how much of it is production code, pre-sales weight, time at customer sites, travel, remote arrangement, level and posted base pay. The site also publishes the aggregates: median pay by level, metro, company and kind of work, and which companies started hiring FDEs each week. Every page under https://nextmove.md/fde is served this way; the index of pages is https://nextmove.md/llms.txt.

# Founding Forward Deployed Engineer (USA)

Canonical URL: https://nextmove.md/fde/jobs/d2fe7fcf1812470c

Pear-VC posts a FDE role to build what the customer runs in Palo Alto, CA and 1 more with no pay posted. A founding software engineer owns technical outcomes for clinical customers, working directly in practices and hospitals to deploy Optexity and build integrations and product features. Read from the employer’s posting on November 8, 2026.

- [Pear-VC](https://nextmove.md/fde/companies/pear-vc)

Posted Nov 2, 2026 by Pear-VC · open on Ashby as of Nov 8, 2026

Pay not posted Palo Alto, CA +1 Remote Full-time

A founding software engineer owns technical outcomes for clinical customers, working directly in practices and hospitals to deploy Optexity and build integrations and product features.

- [See roles that fit me](https://nextmove.md/sign-up?from=%2Ffde%2Fjobs%2Fd2fe7fcf1812470c&placement=top)
- [View posting at Pear-VC](https://jobs.ashbyhq.com/Pear-VC/5d8b4241-8e3d-43db-ab67-0fdc05f10200/application)

Free. Upload your resume once, see why each FDE role fits, and get introduced only when you say so.

## At a glance

### Posted base pay

Not posted

Senior FDE postings, 1,864 postings: the middle 50% of posted pay is $160K to $220K, median $190K.

### The work

Builds what the customer runs

Balance **Mostly building**

Project stages

1. Pre-sales (not covered)
2. Proof of concept (not covered)
3. Implementation
4. Operations

Travel **Required, amount not stated**

- **Coding**: Writes production code

- **Builds for**: External customers

- **Level**: Senior

- **Role**: Individual contributor

### Do you meet what the posting states?

The posting reads as a senior role. What level are you at now?

The work is remote from the US. Can you work from the US?

Which of these have you used in production?

Answer each one. Nothing is saved or sent.

[What postings ask for, by background →](https://nextmove.md/fde/paths)

## Conditions

- **Location**: Palo Alto, CA · New York, NY

- **Work arrangement**: Remote

- **Remote work restrictions**: Preferred to be based in SF; remote also considered.

- **Employment type**: Full-time

- **Travel**: Travel required, amount not stated

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## The job description from Pear-VC

Posted by Pear-VC on Nov 2, 2026

### About Optexity

Optexity is a product-driven research lab building clinical reasoning and computer use models on data no other lab can reach. We deploy directly inside clinics and hospitals — including systems with no APIs, using integration infrastructure we've built and open-sourced — and in return become their preferred partner. That gives us proprietary clinical reasoning trajectories from practicing physicians, and a feedback loop between real patient encounters, our models, and the products built on top of them.

We're a small, fast-moving founding team with multiple published papers in NeurIPS, ICML, CVPR etc and background from Apple, Amazon, Microsoft, CMU, IIT.

We are backed by world-class investors and leaders like Jeff Dean, Neotribe VC, PearVC, Together Fund and Zapier Fund.

### How we work

- **Customer obsession** — we start with the customer and work backwards
- **Intellectual honesty** — ideas matter more than titles; we communicate directly and assume good intent, even in disagreement
- **Bias for action** — we build and learn with customers rather than debate in the abstract
- **Extreme ownership** — we own outcomes, not just tasks, and see problems through

### About the role

You are a software engineer who works directly with our customers. You will be deployed inside practices, clinics and hospitals in New York, understand how doctors and staff actually work, and build the integrations and product features that make Optexity work in their environment. Many of these systems have no APIs, so you will often be building the way in. You will own the customer’s technical outcome from first meeting to daily usage.

### What you’ll do

- Deploy and set up Optexity inside practices and clinics, including systems with no APIs, using the integration infrastructure we’ve built and open-sourced
- Sit with doctors and staff to understand their workflows and requirements, and turn them into working software
- Build and improve data pipelines and integrations with EMRs and other clinical systems
- Work with the core team on our search and chat system, and bring real customer feedback into the product
- Debug and resolve customer issues quickly, and own them until they are fixed
- Help drive customer success: onboarding, training, and increasing usage
- Make general solutions from one-off customer problems, so each deployment makes the next one faster
- Share what you learn with the founders to shape product direction

### Ideal candidate

- Bachelor’s in computer science or a related field
- Strong in Python and comfortable with backend work, data and APIs
- Comfortable working directly with customers, including non-technical ones
- Energized by open-ended problems and takes ownership without needing to be guided
- Genuinely wants a startup over big tech, with speed and ambiguity as defaults, not exceptions

### New Grads Welcome to apply

### Nice to have

- Prior founder, founding engineer or solutions engineering experience
- Experience with browser or desktop automation, or reverse engineering systems with no APIs
- Built LLM-powered products before
- Familiarity with healthcare data, EMRs, or HIPAA
- Strong product taste
- Ambitions to start your own company someday, and we’ll support that path
- Preferred to be based in SF but remote also considered.

### What you get

- Direct, daily work with the founders, plus exposure to board and investor conversations
- Real ownership of technical direction, with scope that grows as the company does
- Full compute and data to do the work properly
- Competitive salary and meaningful equity

[View posting at Pear-VC](https://jobs.ashbyhq.com/Pear-VC/5d8b4241-8e3d-43db-ab67-0fdc05f10200/application)

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