Senior GTM Systems Engineer

Re‑architecting U.S. healthcare demands speed, precision, and an obsession with details. Cadence is building a remote care delivery system that keeps older people healthy, out of the hospital, and at home. By pairing each patient with a dedicated clinical team that reviews their health every day, versus every few months, we catch issues early and intervene before they escalate. The result: measurably better outcomes for patients and less administrative burden for clinicians.Today, Cadence supports tens of thousands of active patients nationwide. Our AI‑powered system and scalable clinical model enable proactive, population‑level care. We’re among the fastest‑growing companies in healthtech, and we’re just getting started.We are seeking a Senior GTM Systems Engineer to help design, scale, and maintain the technical systems that power Cadence’s revenue engine. You will build and automate customer and partner acquisition journeys, create and manage curated datasets, and orchestrate outbound engagement at scale. You will also streamline sales, provider management, and marketing workflows across Salesforce and related tools.This is a builder-first role operating in a fast-moving, high-growth environment where systems, processes, and business needs evolve quickly. You will help design and scale the technical foundation behind Cadence’s GTM organization, bringing structure, automation, and operational maturity while remaining highly adaptable and execution-oriented. We are looking for someone who has experienced growth-stage scale and understands how to build systems that can evolve alongside a rapidly growing company.Note: This engineer will be required to work EST/EDT business hours to provide consistent operational coverage.WHAT YOU’LL DO:Design, build, and maintain our GTM tech stack, ensuring systems are scalable, reliable, and aligned with business needsDesign, build, and automate customer acquisition journeys in Regal.ai using data signals, segmentation logic, and experimentationCurate simplified, actionable datamarts that identify which customers are ready for outreach, reducing reliance on complex, full-scale data ingestionDesign and maintain scalable Salesforce workflows that support B2B and existing customer use cases across the full customer lifecycleBuild API-driven integrations and workflows across Salesforce, Regal.ai, marketing automation tools, and internal systemsDevelop automation and system logic to eliminate manual processes and improve speed, targeting, and conversionBuild observability into GTM systems to detect and troubleshoot issues across journeys, workflows, and data pipelines before they impact performanceManage and enhance marketing automation systems to support high-output engagement across email, scoring, and campaign trackingPartner closely with the Data team to ensure datamarts are accurate, accessible, and structured for dynamic outreach and experimentationEmbed with growth-focused teams to translate business goals into scalable technical solutionsLeverage AI tools such as Claude Code, Codex, and other LLMs to accelerate workflow development, improve targeting, and enhance outbound engagementResearch and evaluate emerging tools and technologies, including AI-driven solutions, to continuously improve the GTM stackHelp introduce scalable operational structure and technical rigor across GTM systems without slowing down business executionDesign systems and workflows that can scale alongside rapid organizational and operational growthParticipate in an on-call rotation to support call center operations and routing systems, ensuring reliability and rapid issue resolutionWHAT YOU'LL NEED:4+ years of experience in enterprise business systems, GTM engineering, or business application technology rolesA systems thinker who can design scalable GTM architecture, not just patch point solutionsStrong cross-functional communication skills with the ability to translate between business stakeholders and technical systemsComfortable operating in ambiguity and rapid growth environments where priorities, systems, and processes evolve quicklyYou know how to balance speed and structure, helping teams scale operational maturity without introducing unnecessary process or bureaucracyStrong builder mindset with a focus on automation, systems design, and eliminating manual workAdvanced SQL skills with hands-on experience building and maintaining datamarts for outreach and segmentation, and comfort working with data warehouse infrastructure such as Fivetran, Snowflake, DBT, and Metabase to build dashboards and funnel analyticsStrong understanding of GTM workflows and how sales, outbound, marketing, and provider teams operate togetherExperience working with platforms like Salesforce, HubSpot, Regal.ai, and marketing automation tools, including building workflows and system logicComfortable working with APIs, webhooks, and event-driven systems to integrate tools and automate processesComfortable going beyond UI-based configuration and building scalable solutions through APIs, automation, code, and systems designExperience managing systems or workflows through code, version control, or reproducible configurations rather than manual setupExperience designing and optimizing automated, data-driven customer journeys, particularly in B2C engagement contextsStrong debugging and problem-solving skills across multi-system workflows, including observability and alertingComfortable using AI tools to accelerate development, improve workflows, and enhance day-to-day productivityHas operated in high-growth environments where systems and processes needed to evolve rapidly alongside company scaleComfortable bringing order and scalability to ambiguous or partially defined operational environmentsHas seen the operational challenges that emerge as companies scale from a few hundred employees into larger growth-stage organizationsAbility to translate business requirements into scalable technical solutionsYou review manual GTM processes, diagnose the root cause, and proactively recommend automations or other solutions in a simple memo-style formatNICE TO HAVE:Experience in high-growth or startup environmentsExperience with experimentation frameworks, A/B testing, or growth analyticsFamiliarity with data pipelines and working closely with data engineering teamsExposure to provider or healthcare-related GTM workflowsHave built or prototyped AI-powered workflows using LLM APIs, Claude Code, or similar toolsExposure to B2B processes such as lead-to-opportunityPrior experience at an early-stage startup where you were one of the first technical hires supporting GTM systemsExperience supporting or scaling GTM systems during periods of rapid company growth (Series B through D/E or similar)Experience with call center or outbound engagement platforms such as Twilio, DialPad, Decagon, or similar toolsWHO WE ARE:We move fast, raise standards, and own outcomes. We hire drivers, not passengers – people who take initiative, solve problems, and sweat the details because lives depend on it. Momentum matters in healthcare where slow decisions cost lives. At Cadence, we set a high bar and back each other relentlessly to clear it. If you’re ready to do the best work of your career and make a real impact in healthcare, join us.WHAT YOU’LL GET:Autonomy to tackle big, complex problems that matterAn opportunity to improve lives every single dayA chance to shape a category‑defining company at scaleMedical, dental, and vision insuranceCompetitive total compensation and meaningful equityTelaDoc (virtual primary care)National and local discounts powered by TriNetUnlimited PTO and paid holidaysRemote equipment setup and home office stipendPaid Parental Leave401K and 401K matchCharitable Donation Match programLocation: RemoteNoteworthyOur job titles may span more than one career level. The base pay for this role typically ranges between $175,000 – $205,000 annual base salary. The actual base pay is determined by a variety of factors, including experience, skills, training, and business needs. Compensation may vary based on market location and is subject to change.Cadence is committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws. A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at https://www.cadence.care/our-team. Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.