Lead Software Engineer — Clinical AI

Lead Software Engineer — Clinical AI Imperial College London spin-out · London, UK (hybrid) · Full-time · Head of Engineering track

About Prelego: Imperial College London med-tech spin-out building AI-powered clinical decision-support tools certified as Software as a Medical Device (SaMD). Flagship product identifies inpatients at risk of preventable harm from EHR data, giving NHS trusts time to act before harm occurs. Venture-backed (Parkwalk Advisors, Imperial College Enterprise Fund), deploying with major NHS trusts. Small, high-ownership team at the intersection of clinical AI and healthcare infrastructure.

The role: Foundational hire, most senior engineering position after the CTO. Own the technical core of a production clinical AI platform — backend services, ML infrastructure and hospital data integrations — and operate as the CTO's second-in-command from day one. Defined path to Head of Engineering: owning technical strategy, hiring and leading the engineering team, sitting at the table for product, regulatory and commercial decisions. Progression milestones agreed up front and tied to company growth.

What you'll do:

• Own and extend the backend and ML infrastructure of a production SaMD system processing real patient data
• Design and implement integrations with hospital systems (EHR, HL7/FHIR), including partnerships with major healthcare data platforms
• Build and maintain Python/Azure-based services — APIs, data pipelines, monitoring and audit frameworks
• Write software to medical-device quality standards, producing design documentation and verification evidence that stands up in a regulatory audit
• Lead projects end-to-end and mentor engineers as the team grows
• Work directly with clinical, data science and regulatory colleagues, direct line to CTO and CEO

Required:

• 6+ years professional software engineering experience with strong Python background
• Proven experience building and operating production services on Azure or AWS
• Comfort with data-heavy systems — pipelines, databases, REST APIs — and a taste for clean architecture
• Experience leading projects or mentoring engineers — sets technical direction rather than waits for it
• Strong written communication; able to document work in a way that survives a regulatory audit
• Right to work in the UK — unable to sponsor visas

Nice to have:

• Experience in a regulated software environment — medical devices (IEC 62304 / ISO 13485), fintech, aerospace or similar
• Familiarity with FHIR/HL7 or clinical EHR data systems
• Exposure to ML model deployment or monitoring in production

Tech stack: Python · Azure · Terraform · ML pipelines · FHIR/HL7 · Docker · GitHub Actions

Compensation: £95,000–£125,000 base + EMI share options (meaningful early-stage allocation); 25 days leave + bank holidays; pension; L&D budget; flexible hybrid, London base.

Process: Intro call (30 min) → technical deep-dive → systems design with CTO → conversation with CEO → offer. Weeks, not months.