Team

The people building Piu.

A small team of operators, clinicians, and engineers — building the daily layer of chronic care.

Ajay
Founder & CEO
  • T2D since 2018
  • 23 years healthcare + fintech
  • Fractional CTO · TPA + PBM

Ajay has been a Type-2 diabetic since 2018. He’s spent 23 years building software for healthcare and financial systems — including stints as fractional CTO at a third-party administrator and a pharmacy benefit manager. He’s seen what gets billed, what gets denied, and what the 15-minute clinic visit actually decides. Almost nothing about the day that follows.

He built Piu Health because the existing tools — Livongo, Noom, ChatGPT — didn’t match how real chronic-care life works. The hard parts aren’t the moments you’re at the doctor’s office. They’re the 364 days between.

“Piu is what I want for the people I love. Including myself.”— Ajay
Nitesh
VP, Enterprise Architecture & Integrations
  • 15+ yrs experience
  • Machine Learning, AI & Full-Stack
  • LLaMA 3.x · Hugging Face

Nitesh owns Piu’s platform architecture, the API and MCP gateways, and the enterprise integrations that connect payers, providers, and EHR systems over FHIR, NCPDP, and X12.

He’s an AI architect and senior full-stack engineer with 15+ years building scalable web, mobile, and AI platforms — and he’s worked every era of applied AI, from classical NLP pipelines still running in production to today’s LLM systems (LLaMA, Mistral, Hugging Face, LoRA / QLoRA). He designs AI that balances innovation with operational stability — not just demos.

“Let’s build technology that lasts.”— Nitesh
Engineering

Six senior engineering leaders. One product.

We’re a small team by design. Six engineering leaders, each with a decade-plus of experience in their domain. No junior layer to manage, no offshore handoffs. The people designing the system are the people shipping it.

Mobile + app

iOS, Android, voice interfaces, on-device inference

  • Swift
  • Kotlin
  • React Native

AI agents + orchestration

193-skill agent mesh, MCP, A2A, JSON-RPC, tool routing

  • Python
  • LangGraph
  • MCP

Model fleet + inference

3-tier model serving — specialist SLMs, LLaMA + LoRA, frontier APIs

  • vLLM
  • LoRA
  • Triton

Infrastructure + deployment

EKS, Karpenter, multi-tenant isolation, RLS, vector indexes

  • AWS
  • EKS
  • Terraform

Clinical NLP + safety

Symptom parsing, drug interactions, escalation thresholds, PHQ/GAD scoring

  • FHIR
  • UMLS
  • spaCy

Cohort science + RWE

Cohort cache, outcomes attribution, RCT analytics, biostats

  • Python
  • R
  • DuckDB

We hire people who’ve already done the hard version of the job somewhere else — and want to do it again on something that matters.

Why this

194 million Americans live with at least one chronic condition. They see a clinician on average once or twice a year. The other 363 days, they’re on their own — with a pile of apps, a printed handout, and a folder of advice that doesn’t quite fit their life.

We’ve tried to build the thing we wish existed for the people in our own families. A daily companion that knows your meds, your meals, your movement, and your mood. That handles the boring 364 days so the clinical visits can be about what actually matters.

We’re not trying to replace anyone’s doctor. We’re trying to make the gap between visits feel less lonely, and less random.

Piu
Open roles

We’re hiring carefully.

We add one person at a time. Each hire stays narrow and deep. If you’ve built the thing we’re describing somewhere else and want to do it again — at a company where the founder reads every PR — we’d like to talk.

Engineering

Staff engineer · clinical NLP

You've shipped FHIR-native NLP at a payer, EHR vendor, or digital therapeutics company.

Clinical

Medical director · chronic care

Practicing endocrinologist or internist, 0.4 FTE, helps us write protocols and review escalations.

Go-to-market

Payer partnerships lead

You've sold or run a clinical program at a regional or national health plan. You know what 'outcomes-shared' means in a contract.

Don’t see your role? Write us anyway — rahul@piuhealth.com

Built in Pittsburgh, Toronto, and Bangalore. Working in your time zone, mostly.