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Thomas Miksch

@thomasmiksch

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Senior AI Full Stack Engineer building agentic, multimodal clinical AI systems that ship reliably.

United States

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What I'm looking for

I’m looking for a Senior role where I can build agentic, multimodal AI systems that scale reliably—from real-time pipelines to secure edge/IoT—while maintaining HIPAA/SOC2-grade compliance and measurable clinical or business impact.

I’m a Senior AI Full Stack Engineer with 7+ years delivering production AI systems across healthcare, real estate, and fintech. I specialize in agentic LLM pipelines, multi-modal AI, and real-time WebRTC/LiveKit infrastructure, with a strong focus on reliability and regulatory compliance.

At Theoria Medical (2022–2026), I led end-to-end development of AI-driven clinical tools—integrating IoT medical devices, voice/video AI agents, and AWS Bedrock-backed LLM services. I scaled platforms from zero to enterprise while improving physician workflows and patient outcomes, including 97%+ task completion across 400+ physician accounts and reduced hallucinations versus a vanilla baseline.

I’ve also architected real-time collaboration and analytics pipelines in production, from PostgreSQL→Kafka→Spark processing to investor dashboards and automated transaction workflows. I bring an engineering-first mindset to agentic, multimodal, and edge-to-cloud systems—always with HIPAA/SOC2-grade guardrails.

Experience

Work history, roles, and key accomplishments

Senior AI Full Stack Engineer

Theoria Medical

Aug 2022 - Apr 2026 (3 years 8 months)

Led end-to-end development of an AWS Bedrock multi-agent clinical decision support system, achieving 97%+ task completion across 400+ physician accounts and reducing unsafe extraction to <0.3%. Built a production multimodal RAG platform over 2M+ de-identified documents and a LiveKit telemedicine platform handling 10,000+ concurrent sessions with <800ms P95 round-trip latency.

Multi agent orchestration LlamaIndex RAG (Pinecone)fastAPI Kafka

Full Stack Engineer

Agora

Feb 2020 - Jul 2022 (2 years 5 months)

Owned an end-to-end real-estate dealflow pipeline for 5,000+ accredited investors, delivering data ingestion through investor dashboards and analytics reporting. Built real-time collaboration and an event/analytics stack (PostgreSQL→Kafka→Spark), reducing investor messaging latency from 900ms to <80ms and powering weekly processing of 500K+ transaction records.

React Next.js WebSockets PostgreSQL Apache Kafka Spark API Integrations (DocuSign Plaid Stripe)Bull + Redis Job Queues

Software Engineer

Ellevest

Dec 2018 - Jan 2020 (1 year 1 month)

Built responsive investment dashboard components and multi-step onboarding flows in React, increasing funnel completion by 22% through UX refactors and A/B testing. Developed Node.js microservices for portfolio event handling and automated trade execution, raising test coverage from 48% to 87% with Jest and React Testing Library and cutting regression bugs by 40%.