Pros
The work is genuinely AI engineering, not buzzword theater — both building AI products for clients and using AI heavily in how we deliver. The healthcare focus (payers, claims, UM/CM, compliance workflows) means the problems are real and the constraints are serious, which I like. Compensation has been strong and fair for the level. The CEO is visibly engaged and the strategy is clear, and leadership is accessible in a way I haven't always had at larger places. The biggest draw is the people: small teams of very senior engineers who would be principals or VPs elsewhere, so the bar for everyone around you is high and you learn fast. There's a lot of ownership — you're trusted to build and ship rather than wait for permission.
Cons
The bar and the pace are both high. The company is in the middle of a real transformation toward a leaner, AI-first delivery model, and that means some ambiguity — roles, process, and priorities are still settling, and you need to be comfortable operating without a lot of structure or hand-holding. Small teams plus fast delivery means you wear several hats. This is a great fit if you're self-directed and senior; it would be a hard environment for someone earlier in their career or who wants well-defined lanes.