Senior Fullstack Engineer
$230,000–$280,000 year
On-siteSan Francisco, California, United States
Job Summary
Architect dynamic, multi-step medical intake engines and high-density provider charting dashboards that handle sensitive PHI with perfect state synchronization. Bridge complex backend medication ordering pipelines to intuitive frontend interfaces, translating dense healthcare requirements into seamless digital experiences. Own the full lifecycle from database schema design and API development to React interface building, deployment, and production error tracking. Integrate frontier agentic models to automate clinical operations and scale provider workflows while maintaining rigorous code review and technical standards. Collaborate directly with clinical leadership to co-design solutions for massive healthcare challenges, ensuring every technical decision prioritizes patient safety and outcomes.
Required Qualifications
- 5-7+ years of full-stack engineering experience
- Experience building and operating production systems that handle real complexity, crossing the boundary between complex backend domain logic and polished frontend user experiences
- Mastery of client-side state and performance
- Ability to manage complex state across a large frontend application
- Understanding of tradeoffs of server-side rendering vs client-side fetching
- Knowledge of caching strategies
- Ability to build interfaces that feel instantaneous even when the underlying healthcare APIs are slow
- Experience getting data modeling right
- Ability to think carefully about schema design and API boundaries
- Experience building things that run in production
- Comfort with or eagerness to master Kubernetes
- Comfort with or eagerness to master Terraform
- Comfort with or eagerness to master AWS
- Experience with CI/CD
- Ability to view deploying own code and owning system's reliability as a fundamental part of the job
- Experience using frontier agentic tools (e.g., Codex 5.3, Claude Opus 4.6) to build faster
- Ability to describe specific ways agentic models have structurally changed how they code
- Ability to retain deep technical skepticism required to audit, verify, and own agentic output
- Low ego
- High standards
- Excellent communication skills
- Ability to thrive in cross-functional environments where engineering requirements are heavily shaped by healthcare regulations, compliance, and patient safety
- Excitement to work in-person
- Willingness to build alongside the team 5 days a week in the San Francisco office
- Demonstrated track record of setting technical direction across teams (for Staff leveling)
- Ability to navigate deep ambiguity
- Ability to measurably level up engineers around you (for Staff leveling)
- Location: San Francisco, CA (5 days/week onsite)
- Must be able to work in-person five days a week
Desired Qualifications
- Experience architecting dynamic, multi-step medical intake engines
- Experience building high-density provider charting dashboards
- Experience building patient-facing apps that handle sensitive PHI with perfect state synchronization
- Ability to translate dense healthcare requirements into seamless digital experiences
- Strong product sense required to make pragmatic, high-quality design decisions on the fly
- Experience designing database schema
- Experience writing APIs
- Experience building React interfaces
- Experience deploying services
- Experience owning backend reliability
- Experience owning client-side error tracking in production
- Experience raising the engineering bar
- Experience owning key architectural decisions across the stack
- Experience systematically upgrading legacy code
- Experience elevating engineers through rigorous code review
- Experience with testing practices
- Experience with technical standards
- Experience mentoring junior developers
- Experience recruiting senior talent
- Experience maintaining a culture of high technical craft
- Experience working directly with clinical leadership to co-design solutions for massive healthcare challenges
- Experience being a deeply technical leader who meets engineers where they are
- Care profoundly about patient outcomes
- Experience with healthcare regulations, compliance, and patient safety
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