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Director, Engineering

San Francisco, California

Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease, the #1 cause of death worldwide, using cutting-edge technology. The flagship product—an AI-driven, non-invasive cardiac test supported by the ACC/AHA Chest Pain Guidelines called the Heartflow FFRCT Analysis—provides a color-coded, 3D model of a patient’s coronary arteries indicating the impact blockages have on blood flow to the heart. Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway that helps clinicians identify stenoses in the coronary arteries (RoadMap™Analysis), assess coronary blood flow (FFRCT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis). Our pipeline of products is growing and so is our team; join us in helping to revolutionize precision heartcare.

Heartflow is a publicly traded company (HTFL) that has received international recognition for exceptional strides in healthcare innovation, is supported by medical societies around the world, cleared for use in the US, UK, Europe, Japan and Canada, and has been used for more than 750,000 patients worldwide.  

We are seeking a Principal Architect to own the technical strategy for platform performance and international expansion. In this role, you will define how the Heartflow clinical platform scales, making it faster and more efficient at growing case volume, and architecting it to operate across new geographies with the data residency, regulatory, and localization requirements each market demands.

This is a hands-on technical leadership role that pairs architecture ownership with direct people management. You will lead a dedicated offshore engineering team based in Eastern Europe, setting the architectural direction and then building and leading the team that executes against it. Success requires deep systems expertise alongside the leadership skills to grow a distributed, cross-border engineering group.

Job Responsibilities

  • Performance Architecture: Own the end-to-end performance strategy for the clinical platform — define latency, throughput, and scalability targets; establish benchmarking and profiling practices; and drive architectural changes that measurably improve case processing time and cost per case.
  • International Architecture: Architect the platform for multi-region operation, including regional cloud deployment topology, data residency and sovereignty controls, failover and availability design, and the abstractions that let a single codebase serve multiple markets.
  • Regulatory & Data Residency: Partner with Regulatory, Quality, Security, and Legal to translate GDPR, in-country data residency mandates, and market-specific clearance requirements (EU, UK, Japan, and new markets) into concrete architectural requirements and controls.
  • Localization & Regional Fit: Define the architecture for internationalization — language and locale support, units and clinical reporting conventions, and regional integration differences across EHR, PACS, and imaging workflows.
  • Offshore Team Leadership: Directly manage and grow a dedicated offshore engineering team in Eastern Europe, owning work allocation, technical quality, delivery accountability, onboarding, and individual development across time zones.
  • Distributed Delivery Model: Establish the operating model for effective onshore/offshore collaboration — documentation standards, design review practices, handoff protocols, and communication rhythms that make a cross-border team productive.
  • Cross-Team Standards: Define, enforce, and evolve architecture patterns, engineering best practices, and tooling standards for performance and multi-region concerns that scale across all engineering teams.
  • Observability: Establish the instrumentation, telemetry, and SLO framework needed to understand and defend platform performance in every region we operate in.
  • Risk Management: Identify performance, scalability, and expansion-related technology risks and dependencies early, and establish mitigation plans with clear owners and timelines.
  • Technical Multiplier: Mentor senior and staff engineers across onshore and offshore teams; raise the architectural bar organization-wide through design reviews, written guidance, and hands-on partnership.
  • Executive Communication: Represent platform architecture in cross-functional leadership forums; communicate technical strategy, trade-offs, and expansion readiness clearly to executive and non-technical stakeholders across Product, Strategy, Operations, Commercial, and Regulatory.
  • Compliance: Ensure all engineering practices across your scope adhere to FDA regulations, HIPAA, and applicable international data protection standards for medical software.

Qualifications required

  • Education: Bachelor's degree in Computer Science, Engineering, or related discipline, or equivalent experience.
  • Experience: 15+ years of relevant industry experience, including significant time in principal, staff, or architect-level roles with cross-team architectural responsibility.
  • Performance Engineering: Demonstrated track record of diagnosing and resolving performance and scalability problems in large distributed systems — profiling, capacity modeling, load testing, database and query optimization, and cost/performance trade-off analysis.
  • International / Multi-Region: Hands-on experience architecting systems for multi-region deployment, including data residency and sovereignty constraints, regional failover, and internationalization/localization.
  • People Leadership: Direct management experience, including managing engineers across time zones; experience leading offshore, outsourced, or contractor teams is required.
  • Technical Proficiency: Deep expertise across system design, cloud-native architectures, and distributed systems; strong familiarity with backend technologies (e.g., Python, Java), database technologies (SQL and NoSQL), containerization/orchestration, and cloud platforms (AWS).
  • Project Experience: Demonstrated experience designing and delivering large-scale, secure distributed systems and platform architectures with measurable cross-team impact.
  • Leadership Skills: Proven experience setting technical vision and architectural standards; track record of mentoring senior and staff engineers and influencing engineering culture organization-wide.
  • Data Protection: Working knowledge of GDPR and comparable international data protection and residency regimes.
  • Methodologies: Experience with Agile development methodologies and project management tools.
  • Security Knowledge: Strong understanding of web and OWASP security best practices.
  • DevOps: Experience with DevOps best practices (e.g., CI/CD pipelines, infrastructure-as-code).
  • Regulatory Understanding: Experience with or demonstrable understanding of FDA regulations and compliance requirements for medical software.
  • Collaboration: Demonstrated ability to work in a fast-paced, collaborative environment and to build trust across geographies and cultures.

How you stand out

  • Experience launching a healthcare or medical device product into a new international market, including the data residency and regulatory architecture work involved
  • Deep hands-on experience with AWS multi-region infrastructure and infrastructure-as-code tooling (e.g., Terraform, CloudFormation)
  • Experience owning performance SLOs and observability platforms (e.g., Datadog, OpenTelemetry) at scale
  • Experience managing engineering teams in Eastern Europe, or working within a GlobalLogic or similar systems-integrator partnership model
  • Experience with medical imaging pipelines, DICOM, or compute-intensive clinical workloads
  • Experience as a technical leader in medical device software or other FDA/HIPAA-regulated environments
  • Fluency or working proficiency in a second language

A reasonable estimate of the yearly base compensation range is $220,000 to $270,000, bonus, and equity.

Heartflow is an Equal Opportunity Employer. We are committed to a work environment that supports, inspires, and respects all individuals and do not discriminate against any employee or applicant because of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law. This policy applies to every aspect of employment at Heartflow, including recruitment, hiring, training, relocation, promotion, and termination.
 
Positions posted for Heartflow are not intended for or open to third party recruiters / agencies. Submission of any unsolicited resumes for these positions will be considered to be free referrals.
 
Heartflow has become aware of a fraud where unknown entities are posing as Heartflow recruiters in an attempt to obtain personal information from individuals as part of our application or job offer process. Before providing any personal information to outside parties, please verify the following: A) all legitimate Heartflow recruiter email addresses end with “@heartflow.com” and B) the position described is found on our careers site at www.heartflow.com/about/careers/. 

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