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Senior AI Engineer — Voice
Miramace
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About this role
ABOUT US
Mira Mace pairs Medicare beneficiaries with a dedicated healthcare advocate who navigates appointments, insurance, and care coordination on their behalf. Our customers get the support of caring nurses while AI agents handle the tedious backend work — all covered by Medicare.
We've felt the pain ourselves — the endless back-and-forth with insurance, surprise bills, and the lack of clarity when you just need answers. Too many people fall through the cracks, and we're determined to change that.
Today, 24/7 personalized health assistance is only available to the rich or extremely sick. Our vision is for everyone to be able to afford a health assistant who knows your health history deeply, navigates the healthcare system on your behalf, and propels you to become the healthiest version of yourself.
Our founding team brings a mix of strong technical experience from companies like Google, Meta, Dropbox, and Amazon, along with serial startup experience ranging from early bootstrapped ventures to Series D scale-ups. We are backed by Foundation Capital, DefineVC and top Silicon Valley angel investors.
WHAT WE'RE LOOKING FOR
We're looking for an engineer to own our voice AI end to end — the calling pipeline, and the quality of every conversation that runs through it.
Our problem space runs on the phone. Getting a customer set up takes a real conversation, and much of the work we do on their behalf can only happen by calling institutions — which means automated phone menus, long holds, transfers, and getting a specific outcome out of someone who didn't expect the call. Many of our customers are older and expect to be spoken with, not processed. Voice AI has to clear that bar, and clearing it is the product.
You'll own the full real-time stack and the systems that make it measurably better with every release: evaluation for calls, replayable regression suites, and the tooling that tells us why a call went wrong before a customer does. You'll work directly with the founders and with the team that listens to these calls every day.
This role is specifically for someone with real voice experience. If you've shipped a production real-time voice agent, we want to talk.
RESPONSIBILITIES
- Own the voice pipeline. Build and operate the real-time stack — telephony, streaming speech-to-text, LLM orchestration, text-to-speech, endpointing, barge-in, and the latency budget that keeps a conversation feeling human.
- Drive call quality relentlessly. Define what a good call is, measure it, and move the number. Build the evaluation harness — replayable audio and transcripts, regression suites, per-turn scoring — so quality changes are provable rather than anecdotal.
- Handle the real world. Automated phone menus and DTMF, holds and transfers, voicemail, dropped calls and retries, noisy lines, accents, interruptions, and speaking clearly with an older audience.
- Scale calling volume reliably. Make the system hold up across thousands of calls a day, with clean handoffs to a human when the agent should stop.
- Close the loop with the people who hear every call. Turn what our team observes on real conversations into prompt, model, and pipeline changes, fast.
- Ship fast and iterate with real users. Deploy to production, listen to real conversations, and improve from them — in days, not quarters.
- Lay the foundation for scale. Make architectural decisions in the voice stack that hold up from hundreds of calls a day to hundreds of thousands.
QUALIFICATIONS
- You've built and shipped real-time voice AI to production — not a demo, but a system that took real calls with real people.
- Hands-on depth across the voice stack: streaming speech-to-text, text-to-speech, turn detection and endpointing, barge-in, and latency optimization under a real-time budget.
- Experience running telephony in production (SIP/PSTN, Twilio or similar) and the failure modes that come with it.
- You've built evaluation for voice or conversational systems.
- You've debugged AI systems in production and can trace a bad outcome through audio, transcript, and model behavior to the actual cause.
- You're comfortable with ambiguity. The playbook doesn't exist yet, and you're excited to build it.
NICE TO HAVE
- Experience with real-time voice agent frameworks.
- Speech model fine-tuning, custom vocabularies, or domain adaptation for specialized terminology.
- Experience building agents that navigate automated phone systems on the other end of the line.
- Experience in healthcare or another regulated industry (HIPAA, PII/PHI handling, call recording and consent).
WHO YOU ARE
Beyond technical skills, we're looking for someone who embodies the attributes that make great engineers at an early-stage company:
- Proactive. You move quickly and take a forceful stand without being abrasive. You act without being told what to do and bring new ideas to the company.
- Analytically sharp. You structure and process qualitative or quantitative data and draw penetrating insights. You learn quickly and absorb new information with ease.
- High standards with attention to detail. You expect nothing short of the best from yourself and your team. You don't let important details slip through the cracks or derail a project.
- Passionate and open. You exhibit enthusiasm and a can-do attitude over your work. You solicit feedback often and react calmly to criticism or negative feedback.
OUR CULTURE
Everything we do is guided by a set of leadership principles that define how we operate:
- Patient First. We start with the patient and work backwards. Every decision — what we build, who we partner with, how we operate — is filtered through one question: does this make the patient's life better?
- Sense of Urgency. Every day a patient goes unnavigated is a day someone needing help couldn't get the support they needed. We move fast, make decisions with conviction, and carry urgency toward the l
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This posting doesn't disclose pay. Across 6,373 San Francisco jobs with disclosed salaries on ForgeApply, the median is $204k.
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