Senior Engineering Manager, AI Accounting & Ledger Systems
- Salary
- $240K - $275K
- Level
- Lead
- Work type
- Hybrid · Mountain View
Not stated in the posting: visa.
Open. First seen 26 September 2026.
About the role
Commure's standard text
At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs.
Healthcare carries a $1 trillion administrative burden and we're at the center of transforming it. Today, 500,000+ clinicians across 500+ healthcare organizations nationwide trust Commure to handle $25B+ in annual claims and support over 200 million patient interactions. Our latest $70M raise at a $7B valuation reflects the confidence the market has placed in this mission. We've also been named to the Fortune Future 50 list and the 2026 AI Breakthrough Awards for “Overall NLP Company of the Year.”
Commure's standard text
Our team works directly alongside clinicians, not through layers of process, which means the gap between what you build and its impact on patient care is immediate. We move fast, deploy daily, and take full ownership from early thinking to production. If you're energized by hard problems, high stakes, and a team that holds itself to a high bar, you'll find your people here.
The future of healthcare is being built right now. Come deliver this transformation.
About the Role
We're hiring a Senior Engineering Manager for the team that owns the financial core of our revenue cycle product. That's three things: the ledger that records every financial event, the reports that billing managers and CFOs close their books on, and the analytics that tell a practice how it's doing.
You'll manage 6 to 8 engineers, from early-career to Senior Staff, own the roadmap with your product partner, and be accountable for financial correctness across the platform. We're partway through rebuilding this surface: moving a decade of report logic onto a drift-free ledger and a modern OLAP layer, while customers keep closing their books on the old one.
What You'll Do
- Manage and grow a team of 6 to 8 engineers. Hiring, performance, career growth. Build people who can each run a customer escalation, a data migration, or an incident end-to-end without you in the room.
- Set the roadmap with your product partner. The goal is to get from building whatever report a customer asked for to customers building their own reports and closing their books without us involved.
- Own financial correctness. For this team, wrong numbers are a worse failure than a slow page. You'll own the systems that catch silent errors: shadow parity harnesses, cross-report tie-out checks, drift monitoring, and correctness SLOs next to the uptime ones.
- Lead multi-quarter migrations (ledger report migration, OLAP golden views) incrementally, with parity checks at each step, without breaking anyone's close.
- Own the customer relationship at the top of the stack. Sit with comptrollers, CFOs, and RCM directors at our largest sites during month-end. Turn their definition of "correct" into software, and turn recurring escalations into roadmap.
- Run cross-team execution with the payments/posting team, data infrastructure, and ops so upstream changes don't quietly break downstream numbers.
What You Have
- 5+ years managing software engineers, including senior and staff-level ICs. You've grown engineers into leads and staff engineers, and you can name them.
- You've shipped financial, reporting, or data-intensive systems in production where the numbers had to tie. You know how a report can be technically correct and still wrong to the person reading it.
- Backend and data fluency. You can review a query plan, push back on a ledger design, and debug a parity failure yourself. Staff engineers will take you seriously because you engage with the substance.
- You've set direction for a product surface and can say what it should look like in 12 months.
- You're comfortable across the table from a CFO explaining why a number moved.
- Operational discipline: on-call, SLOs, and monitoring for correctness as well as availability.
- You move fast on incomplete information and reset timelines honestly when the work turns out bigger than expected.
Nice to Have
- Healthcare RCM, billing, practice management, or clearinghouse background. Or fintech experience with ledgers, close automation, or reconciliation (BlackLine, FloQast, Numeric, Stripe, Modern Treasury).
- OLAP stores (StarRocks, ClickHouse, Druid) run alongside PostgreSQL.
- Double-entry accounting, append-only ledgers, or audit-trail requirements.
- Leading a platform re-architecture while keeping the existing system shipping.
- Shipping LLM features to production. We run an AI report builder that handles thousands of custom reporting requests.
Commure's standard text
Please be aware that all official communication from us will come exclusively from email addresses ending in @commure.com. Any emails from other domains are not affiliated with our organization.
Employees will act in accordance with the organization’s information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. Employees will be required to attest to these requirements upon hire and on an annual basis.
What this role asks for
Particular to this role
ClickHouse
Rare in Commure's other 42 open postings.
In most of Commure's ads
NLP
Named in most of its open postings, whatever the role.
80% of this description is written for the role. The rest is Commure's standard text, folded away below.
Read against Commure's other open postings on this site.
The team: Engineering HIRES STEADILY
This role is one of 34 open in Engineering. 15 were posted in the last 30 days and the oldest in April: a team that hires all year rather than one being built.
WHAT THE TEAM WORKS WITH, ACROSS ITS POSTINGS
NLP (34 of 34), Python (21 of 34), LLM (17 of 34), JavaScript (15 of 34), Kubernetes (15 of 34), React (15 of 34), PostgreSQL (12 of 34)
OTHER ROLES ON THIS TEAM
- Senior Software Engineer, Network Infrastructure posted Oct 15
- Senior Software Engineer, Agent Platform posted Oct 14
- Senior Software Engineer, AI Billing (Brazil) posted Oct 6
- Software Engineer, AI Integrations posted Oct 6
- Senior Software Engineer, AI Integrations posted Oct 6
- Senior iOS Engineer, Ambient AI posted Oct 6
- Staff Backend Engineer, Ambient AI posted Oct 6
- Senior Software Engineer, RCM Email Agents posted Oct 5
- Senior Software Engineer, Air AI posted Sep 25
- Senior Engineering Manager, Payments & Reconciliation posted Sep 23
- Software Engineer, Scribe AI posted Sep 23
- Senior Software Engineer, Voice Agents posted Sep 23
- Software Engineer, Voice Agents posted Sep 23
- Software Engineer (India) posted Sep 23
- Senior Software Engineer, Billing Agents posted Sep 9
- Staff Software Engineer, Data Warehouse posted Sep 4
- Senior Software Engineer, Infrastructure posted Sep 4
- Engineering Manager, AI Orchestrator posted Sep 2
- Senior Backend Engineer, Ambient AI posted Aug 19
- Senior Fullstack Engineer, Ambient AI posted Aug 19
- Fullstack Engineer, Ambient AI posted Aug 19
- Software Engineer, AI Billing posted Jul 29
- Staff Software Engineer, Accounts & Ledgering posted Jul 20
- Staff Software Engineer, Data Integrations posted Jul 20
- Software Engineer, AI Billing (Brazil) posted Jul 20
- Software Engineer, Billing Agents posted Jul 17
- Staff Software Engineer, Billing Agents posted Jul 15
- Senior Software Engineer, R&D posted Jun 27
- Forward Deployed Engineer posted Jun 26
- Senior Forward Deployed Engineer posted Jun 25
- Senior Software Engineer, AI Billing posted Jun 23
- Software Engineer, Athelas Home posted Apr 21
- Senior Fullstack Engineer, Commure Pro posted Apr 21
From the team and dates on Commure's own job board.
See Engineering Manager salaries in the United States →
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