How we found a US healthcare AI company its first engineering leader in India
A venture-backed US healthcare AI company wanted to start engineering in India. Here is how we ran that search, from the first brief to a shortlist.
Mandate file
Retained
Client
Venture-backed healthcare AI company, US headquarters
Role
Head of Engineering, India
Remit
Set up and lead India engineering and R&D from the ground up
THE NEED
A US healthcare AI company wanted a hands-on engineering leader to start its India team from scratch, as employee #1.
WHAT WE DID
We turned the brief into criteria, mapped four talent pools, verified 15 profiles and presented six.
THE RESULT
The client interviewed three. One took the offer and joined.
Why this was a hard role to fill
The client. A venture-backed US healthcare AI company. Its AI agents handle phone-based admin for payors, pharma companies and providers, work that usually runs through call centres. All of its engineering sat in the US.
The role. Employee #1 in India. Whoever took it would decide what the team owned, how it was structured, who joined and what the culture felt like. The company wanted a flat organisation and gave real autonomy.
The catch. The brief was demanding. The client wanted someone still hands-on with the technology, who had built something from nothing, understood AI, and was happy to start under an employer-of-record arrangement. People like that are rare, and most of them already have senior jobs. The client also wanted them started about six weeks after we delivered the shortlist.
Turning the brief into something we could test
Before we contacted anyone, we turned every line of the kickoff brief into a criterion. These are the lines that changed our ranking after the first slate.
What the client said
What we did with it
Employee #1 in India, setting up from scratch
We looked hard for proof of building from scratch: a first India hire, a site builder for a global company, or a founder.
Strong technical depth, not a people-management or delivery profile
Hands-on depth became our first test. If a career read as delivery or people management, we passed.
Start-up experience and comfort with a flat structure
We judged this on its own, so a big-company leader couldn’t win on scale alone.
Product understanding and a builder mindset
We looked at product ownership and AI depth separately, because one doesn’t guarantee the other.
Healthcare is good to have, not mandatory
We dropped it as a criterion. Strong builders from other sectors stayed in.
Preferred: worked in the US, then returned to India
We counted it in a candidate’s favour, as the client preferred.
A start date about six weeks after the shortlist
We judged how likely each person was to move, and told the client early what notice periods would do to that date.
Where we looked, and why
Each pool was a bet on where this kind of person works. We also wrote down who we were leaving out, and why.
India site builders for US start-ups
People who had already done this exact job: first India leader, then the team.
Where: engineering heads of India sites at US-headquartered AI and SaaS start-ups.
Tier-1 engineers who became founders
The profile the client held up as its benchmark: a deep technical record, then a company of their own.
Where: senior and staff engineers at large technology and data companies in Bengaluru, plus research-lab alumni.
Hands-on builders available now
Our best shot at an early start, since most senior leaders serve a long notice period.
Where: fractional CTOs, advisors and recent exits.
People we ruled out
India-market start-up CTOs, and people and delivery leaders from large organisations.
Why: the client’s own feedback and the kickoff screen-outs.
Building a founding engineering team?
Opening a new engineering centre, or hiring the first leader of a function? Talk to us and we'll walk you through how we'd run your search.
The 15 we verified, weak spots included
This version is reassessed against the kickoff brief. We listed every profile’s main gap, because the client should hear the weak points from us first. The table opens on the top six by our ranking.
#
Background
Years
US Work
Main gap
01
First India site leader for a US AI start-up, after a decade on internet-scale systems at a Big Tech major. Co-founded a company earlier.
25+
Yes
Team size unknown. Current employer will likely counter-offer.
02
Two-time founder and hands-on VP Engineering, with an acquisition. Now on a large-model team at a Big Tech major.
20
Study only
No US work experience. Largest team led was mid-sized.
03
Many years in the US at two Big Tech majors, then returned to bootstrap teams in Bengaluru. Now leads an AI R&D site.
15–19
Yes
No founder role. The employer-of-record set-up may give pause.
04
Serial start-up engineering leader (VP Engineering, CTO). Now a fractional CTO and AI advisor, available now.
21
No
Pedigree lighter than the benchmark. Last full-time executive role was in 2019.
05
Closest technical match to the benchmark: doctorate, industrial research, Big Tech staff engineer, now senior staff at a data platform. Spent seven years running their own company.
21
Yes
Couldn’t verify the scale of teams led. No AI product evidence on the profile.
06
Founder-CEO and CTO with three ground-up builds, including a US start-up exit. Now CTO of a large Indian firm.
24+
Yes
The India head seat is a step down in scope.
What we flagged before the first call
A big part of the job is telling the client what is going to slow things down before it does.
Start date versus notice periods
Senior notice periods in India usually run 60 to 90 days, so employed candidates would typically join one to three months after the client’s target date. Only two people on the shortlist looked free any sooner.
A fallback if the date was fixed
One profile, a fractional CTO and advisor, could realistically start on the client’s date. We named that person as the fallback.
What candidates were going to ask
We asked the client to settle three things before outreach: how flexible the start date was, where they stood on equity, and how long the employer-of-record arrangement would last before an Indian entity existed.
How the interview process went
Four conversations, with us coordinating all of them. We handled the scheduling and collected feedback throughout.
Functional discussion
A first conversation about scope, background and what the role really involved.
Leadership conversations
Time with the client’s leadership, including the CTO and the CEO.
Technical discussion
A working conversation on architecture, design decisions and depth in modern product engineering.
Culture conversation
A check on how well the person fit a flat, early-stage way of working.
What to expect if you retain HRBx
You can see each of these in the search above.
Your brief, turned into criteria
We turn every line of your brief into something we can test.
Weak spots upfront
Every name arrives with its main weakness next to its strengths.
Timeline problems, flagged early
We raise notice periods, counter-offers and scope mismatches before they bite.
A search that adapts with every piece of feedback
Every no from you sharpens the next list.