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A mission-driven healthcare technology organization focused on improving health equity for underserved populations across the United States. Through a scalable patient engagement and interoperability platform, the organization partners with healthcare providers to increase access to care, improve clinical outcomes, and address social drivers of health. The engineering team operates in a fully distributed environment and is scaling its integration capabilities to connect with leading EHR systems and healthcare data platforms. The team values secure, reliable, and maintainable engineering practices, with a strong emphasis on interoperability standards and cross-functional collaboration. You’ll join a collaborative, high-performing engineering team that works closely with Product, Customer Success, and external healthcare partners to deliver meaningful technical solutions that directly impact patient outcomes.
Job Responsibility:
Design, build, and maintain scalable backend services using Ruby on Rails, JavaScript, and relational databases, supporting high-volume messaging workflows, APIs, and system integrations
Develop and optimize messaging pipelines that support SMS, voice, and automated communication workflows, ensuring reliable delivery, consent management, scheduling, and orchestration of communications
Build and maintain secure API-to-API integrations that connect messaging platforms with external systems and services, ensuring reliable data exchange and workflow automation
Collaborate with engineering teams to design and evolve scalable messaging infrastructure, contributing to architectural decisions related to delivery optimization, system performance, and event-driven communication workflows
Leverage advanced SQL and analytical thinking to investigate system behavior, troubleshoot production issues, analyze delivery performance, and inform technical decisions with data
Partner closely with Product, Customer Success, Data, and Engineering teams to gather requirements, contribute to technical documentation, clarify workflows, and design messaging features that support business and user needs
Provide technical mentorship through code reviews, design discussions, and collaborative development, helping guide engineering best practices and supporting the growth of other engineers on the team
Write and maintain automated tests alongside production code, ensuring backend services are secure, reliable, and production-ready
Create clear technical documentation and internal enablement resources that help teams monitor, troubleshoot, and support messaging systems in production
Participate in on-call rotations and incident response, supporting messaging infrastructure to maintain high availability and performance
Actively contribute to engineering culture through technical reviews, retrospectives, architecture discussions, and technical debt management, helping evolve platform capabilities as the system scales
Requirements:
Minimum 5 years of hands-on software engineering experience, with strong proficiency in Ruby on Rails and JavaScript
Minimum 5 years of experience building and scaling backend systems, APIs, and services
Strong understanding of software development lifecycle, design patterns, object-oriented programming, and engineering best practices
Advanced SQL proficiency with the ability to analyze large datasets to troubleshoot issues and inform technical decisions
Experience designing and supporting high-throughput backend systems and distributed architectures
Experience working in environments where automated testing is a core development practice
Demonstrated ability to independently own complex features end-to-end, from technical design through production support
Strong collaboration skills across technical and non-technical stakeholders
Excellent written and verbal communication skills in a fully remote environment
Growth-oriented mindset with strong attention to system reliability, scalability, and engineering quality
Nice to have:
Experience working with messaging and communication platforms (e.g., SMS, voice, or messaging APIs)
Experience designing event-driven systems, message queues, or high-throughput delivery pipelines
Experience with Ruby on Rails, JavaScript (React), PostgreSQL, and cloud platforms
Experience working with healthcare technology platforms or healthcare data integrations
Experience contributing to API design improvements, messaging delivery optimization, or automated testing strategies
Familiarity with messaging compliance requirements such as TCPA, consent management workflows, opt-out handling, or A2P messaging frameworks