Pelago is the leading specialty substance use care provider, built on the belief that effective treatment means matching care intensity to what each member actually needs rather than defaulting to the most expensive intervention. Our programs guide members through every stage of the substance use spectrum, from unhealthy habits to active use disorders, delivering personalized treatment for tobacco, alcohol, opioid, cannabis, and stimulant use based on individual health, habits, genetics, and goals.
With Sona, our voice-first AI Mental Health Specialist, Pelago now applies that same clinically-driven model to mental health, pairing deep clinical expertise with technology to expand access without compromising care quality. We believe technology should make clinical care more precise and more human, not replace the judgment behind it.
Pelago has scaled to helping hundreds of employers and health plans and has already helped more than 750,000 members better manage their substance use. If you're passionate about AI and making an impact on the health of others, join us and make it happen!
About Pelago Engineering:
Our engineering team operates as empowered, outcome-oriented problem solvers, working in close partnership with product, design, and clinical teams to improve member outcomes at scale.
As AI transforms how software is built, we are intentionally evolving our development lifecycle so we spend less time on mechanical implementation and more time on system design, judgment, and impact.
How We Work:
- Outcome-driven: Engineers are given problems to solve, not just features to build. Success is measured by learning, impact, and outcomes—not velocity alone
- AI-native: We use AI across the SDLC to accelerate implementation, testing, and review. Engineers focus on defining intent, validating behavior, and designing resilient systems
- High autonomy, high accountability: Teams have real ownership over their domains. With autonomy comes responsibility for quality, safety, and results
- Cross-functional by default: Engineers partner deeply with Product, Design, Data, and Clinical. Discovery, experimentation, and delivery are shared responsibilities
- Quality and safety matter: We build in a regulated, member-impacting domain. Reliability, observability, and correctness are first-class concerns
What You’ll Do:
Instead of task lists, anchor on ownership:
- Own meaningful problem spaces end-to-end, from discovery through delivery and iteration
- Design and evolve systems that support safe, scalable, AI-augmented development
- Use data and experimentation to validate whether solutions actually work
- Collaborate cross-functionally to balance member impact, clinical constraints, and technical tradeoffs
- Shape how we work—our tools, processes, and culture
What We Look For:
We explicitly assess for empowerment:
- You start with "why" before diving into "how"
- You're energized by ambiguity and collaborative problem-shaping
- You use AI to amplify your judgment and move faster on what matters
- You think in systems and anticipate second-order effects
- You want to own outcomes, not just ship features
Overview of the Role:
Pelago is looking for an Engineering Manager to lead and grow a high-performing team building AI-native products that improve outcomes for people living with substance use challenges.
We believe the best leaders are also builders. In this role, you’ll lead from the front: pairing with engineers, architecting systems, and setting a high bar for technical excellence and curiosity across the team. You won’t just tell the team what to do; you’ll be in the trenches with them, prototyping, debugging, and helping turn ambitious product ideas into robust, user-facing features.
You’ll foster a high-autonomy, high-accountability culture where engineers thrive, and you’ll help Pelago scale secure, reliable AI systems that patients and providers can trust.
This is a hybrid role with a high-collaboration rhythm (3 days/week in our NYC office).
In this role you will:
- Lead and grow a high-autonomy, high-accountability engineering team, mentoring engineers and fostering a culture of ownership, curiosity, and excellence.
- Lead from the front as a hands-on builder, pairing with engineers to prototype, debug, and deliver robust, user-facing product experiences.
- Drive end-to-end execution of AI initiatives, from rapid experimentation through secure, reliable production deployment with a high bar for quality and trust.
- Help grow and strengthen our NYC engineering presence while collaborating closely with our London team, serving as a culture carrier and talent magnet as Pelago scales globally.
- Shift the team from output to outcomes, framing ambiguous problem spaces, running fast learning loops, and ensuring work is measured by real member and business impact.
- Set technical direction and raise engineering standards, focusing reviews and decision-making on architecture, system behavior, and long-term scalability rather than implementation minutiae.
The background we are looking for:
- Experience leading one or more engineering teams with accountability for technical execution, delivery, and quality across architecture, development, and production in fast-paced environments where speed and quality both matter.
- Proven success guiding teams through the end-to-end delivery of complex, user-facing, AI-native products, from system design and technical decision-making through production and iteration.
- Demonstrated ability to hire, mentor, and develop engineers across multiple career stages, fostering high-performing teams with strong ownership and accountability.
- Strong technical judgment, with a track record of making sound tradeoffs around experimentation, technical debt, and long-term scalability.
- Deep experience partnering cross-functionally with Product, Design, Data, and Clinical to align technical execution with user, clinical, and business outcomes.
- Experience operating in high-growth, high-urgency environments, with a bias toward action, iteration, and forward momentum.
- Strong judgment balancing speed and quality in fast-moving product cycles with meaningful technical complexity.
What you’ll love about us:
We have a whole host of perks for our people! From life essentials to nice-to-haves, there are more than a few good reasons to love working with us. We strive to ensure Pelago employees have equitable access to healthcare, wellbeing, time away, and then some.
- Generous and meaningful equity package
- Full Medical, Dental, & Vision coverage
- 401k Plan
- Unlimited PTO Policy, 10 paid holidays, & company wide “Me Time” Days
- Paid maternity, paternity & new parent leave
- Flexible working environment
- Annual Learning and Development stipend to support continued learning and career development
- Wellness Reimbursement Program
- Access to Reproductive & Family Planning Care
- Substance Use Support for employees and family members
At this time, we are unable to offer visa sponsorship for this position.
Please note that Pelago is dedicated to providing accommodations to candidates upon request. If you need accommodations at any point throughout the interview process, please reach out to your recruiter.
Before you apply, see how we build.
We write about our technical decisions, product philosophy, and the real challenges of scaling behavioral health. Read the blog → https://pelagohealth.ai/
