About Pearl

Pearl is shaping the future of dentistry with a suite of AI solutions developed to establish higher standards of quality and care for patients worldwide. Since 2019, our team has engineered FDA-cleared computer vision capabilities for interpretation of 2D and 3D dental imagery — industry-leading capabilities which clinicians, practice owners, labs and insurers use to elevate the efficiency, accuracy and consistency of dental care around the world.

The Role

We're looking for a Senior Engineer who is a true self starter- someone who sees an ambiguous problem space, defines the path forward, and ships. Rather than waiting for tickets, this person will identify what needs to be built, make the call, and drive it to production. This role sits at the center of Pearl's agentic product strategy. You'll be building autonomous systems that reason, act, and integrate, across the dental practice- work that defines what AI can do in clinical operations, not just what it can describe.

Key Areas of Focus

Agentic Systems (primary focus): Design and build agents that plan, call tools, and take action across internal services and external systems. This includes tool-calling workflows, ReAct-style loops, MCP-based integrations, evaluation harnesses, and the safety guardrails that make autonomous behavior trustworthy in a clinical context.
Real-Time Clinical AI Workflows: Contribute to systems that capture clinical audio, stream transcription, and generate structured documentation using LLMs.
Dental Data Intelligence: Help develop pipelines that ingest, normalize, and enrich data from practice management systems — the substrate our agents reason over.

What You’ll Do

Architect and build agentic systems: tool-calling loops, orchestration patterns, memory, retries, and evaluation
Define and enforce safety guardrails for autonomous workflows operating on clinical and operational data
Integrate agents with internal Pearl services and third-party tools via MCP and direct APIs
Build evaluation pipelines and observability for agent behavior — measure what’s actually working in production
Contribute to real-time transcription and LLM-powered summarization pipelines
Develop across the stack: Node.js/TypeScript APIs, React frontends, PostgreSQL, and AWS
Support event-driven architectures using Kafka, SQS, or similar technologies
Own prompt engineering, structured output design, and model selection decisions for your domain
Identify gaps in the system before anyone files a ticket, then close them
Work with AI development tools (e.g., Cursor, Claude Code, Copilot) as a core part of your workflow

What You’ll Need to Succeed

5+ years of professional software engineering experience
Self-starter by default. You operate well without detailed direction. You scope your own work, make tradeoff decisions independently, and deliver — then bring the result back for discussion rather than waiting for permission to begin.
Comfort with ambiguity. You can take a vague problem (“our agent should handle this class of request”) and turn it into a working system without a detailed spec
Hands-on experience building LLM-based systems: prompting, structured outputs, tool/function calling
Experience designing or contributing to agentic patterns — ReAct, tool-calling loops, multi-step reasoning, or similar
Strong backend skills with Node.js / TypeScript
Experience with React and modern frontend development
Familiarity with AWS (Lambda, SQS, S3, Bedrock preferred)
Experience with PostgreSQL and data modeling fundamentals
Exposure to event-driven systems (Kafka, SQS, etc.)
A real testing and observability practice — agentic systems fail in subtle ways and you know how to catch it
Daily use of AI-assisted development tools in your workflow

Nice to Have

Experience shipping production agentic systems (not just prototypes)
Familiarity with MCP (Model Context Protocol) or comparable tool integration frameworks
Experience with agent evaluation frameworks (LangSmith, Braintrust, custom eval harnesses)
Experience with speech-to-text systems (Deepgram, Whisper, AWS Transcribe)
Healthcare or dental technology background
ETL pipeline or data integration experience
Multi-tenant SaaS experience
Infrastructure as Code experience (e.g., Serverless Framework, CDK)

What We Offer

Competitive compensation and benefits
Ongoing training and development opportunities
Flexible, uncapped PTO
Remote work environment

Senior Agentic Software Engineer