📌 About Alpaca Health
Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.
We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: shift power in healthcare away from large consolidated entities and back to clinicians.
We've raised over $14M in funding from early-stage investors like Core Innovation Capital, Adverb Ventures, and South Park Commons, and are building for long-term category leadership. More importantly, we're serving hundreds of patients, while growing 30% MoM.
This role is full-time. We’re looking for candidates based in NYC or open to relocating who are open to 5 days a week in the office.
🎯 Role
Payroll is the part of our product that people notice most when it goes wrong.
Our customers are clinic owners. Many of them left larger organizations to start something of their own, and they now have RBTs and BCBAs depending on them for a correct paycheck every two weeks. When payroll works, they get to focus on clinical care. When it doesn't, it's the only thing they can think about.
You'll own that outcome.
You'll run payroll operations across dozens of independent clinics in multiple states — every cycle, every correction, every state registration, every confused employee asking why their check looks different this week. You'll also own our payroll platform itself, which is powered by Salsa: configuring it, catching problems before customers do, and telling our engineering team exactly what needs to change.
This is a customer-facing role and an operations role at the same time. You'll be the person clinic owners email when something is wrong, and the person inside Alpaca who knows more about payroll than anyone else.
There is no playbook for this yet. You'll write it.
🚧 What You’ll Do
Run Payroll for Dozens of Clinics
Own the cycle end to end, for many separate employers at once.
This includes:
Pre-run review and variance checks
Hours and timesheet reconciliation against session documentation
Approvals, funding, and submission
Post-run verification
Off-cycle runs, retro pay, and overtime corrections
Terminations and final-pay deadlines
Garnishments, reimbursements, and adjustments
You'll build the checks that catch errors before a customer does.
Be the Owner of Our Payroll Platform
Our payroll infrastructure runs on Salsa. You'll understand it more deeply than anyone else at Alpaca.
Configure new clinics and new employees
Diagnose issues down to the root cause, not the symptom
Decide what's a customer question, a configuration problem, or a bug
Write the tickets our engineers work from
Push for the platform changes that eliminate recurring manual work
You'll constantly ask:
"Why did this happen, and how do we make it impossible next time?"
Handle Multi-State Compliance
Our clinics operate across many states, and every state has opinions.
State tax and unemployment registrations
TPA and third-party access setup
Sick leave, overtime, and pay transparency requirements
Wage notices and required disclosures
Filing deadlines and agency correspondence
You'll be comfortable on hold with a state agency, and you'll document what you learn so nobody has to learn it twice.
Support Clinic Owners Directly
You're the human on the other end of a stressful email.
Explain a paycheck to someone who thinks it's wrong
Tell an owner what happened, what you're doing about it, and when it'll be fixed
Walk new clinics through onboarding onto payroll
Turn a bad payroll moment into a reason someone trusts us more
Great payroll support is clear writing under pressure
.
Build the Systems That Make This Scale
We will not staff our way through growth.
Document every workflow, exception, and edge case
Build the checklists, templates, and calendars that keep cycles predictable
Use AI and automation to remove the repetitive parts of your own job
Turn recurring escalations into product requests
You'll leave behind a function that runs better than when you found it.
🧠 Who You Are
You are extremely ambitious and want to build something meaningful at high velocity.
You are comfortable working harder and moving faster than most people.
You are AI-native—you already use tools like Claude Code, Cursor, or similar to build and prototype.
You thrive in environments with little structure and high accountability.
You are a systems thinker who instinctively turns chaos into repeatable processes.
You can manage a large volume of parallel priorities without dropping details.
🚀 Why Join
Direct exposure to company-building at an early stage.
Real ownership of critical initiatives from day one.
The opportunity to materially impact families and clinicians.
A fast learning curve that few roles can match.
Strong compensation package
💵 Competitive salary
📈 Meaningful equity
🏥 Health benefits
🏖️ Flexible PTO
🍱 Dinner when working late
Seeking an ambitious, AI-native systems thinker who can manage payroll operations, multi-state compliance, customer support, platform configuration, and process improvement in a fast-paced environment.
Key Responsibilities
- running payroll
- supporting owners
- building systems
Skills & Tools
Salsa, Claude Code, Cursor
Job Details
- Category: Business Operations
- Seniority: Mid Level
- Commitment: Full Time
- Workplace: Remote — United States
- Languages: English
Benefits
- Generous paid time off
About Alpaca Health
A healthcare technology company helping clinicians launch and scale autism care clinics. — Industry: Healthcare