Principal Staff Engineer

Our stealth health tech company is a mission-driven organization dedicated to revolutionizing user experience in healthcare for patients, families and caregivers. Our agentic health platform integrates patient records, curates resources and helps to guide and coordinate care. We believe that every patient deserves a clear path to better health, and we’re using AI to make that possible for everyone, including those facing life-altering conditions requiring guidance, complex care navigation, and support resources.

Position Summary

We are seeking a Staff / Principal Engineer to build and ship the production systems at the core of our platform. This is a deeply hands‑on role, working side by side with our Head of Engineering as our early engineering team: you'll take feature briefs from concept to delivery across our mobile, web, and backend stack, help shape the technical direction while holding a high bar for quality and security in a healthcare context, and treat AI coding agents as a core part of how you build. With a small, distributed, asynchronous team, clear written communication and strong judgment about when to move and when to sync are essential.

Key Responsibilities

• Design, build, and ship production features end-to-end across our mobile, web, and backend systems—owning work from feature brief through delivery without hand‑holding.
• Build robust APIs and services using modern async web frameworks, with sound schema validation, structured error handling, and reliable database migration workflows.
• Implement secure authentication and authorization—token lifecycle, secure storage, silent refresh, and fine‑grained (field‑level) access control appropriate to handling protected health information.
• Use AI coding agents fluently as a daily part of your workflow: directing them to scaffold features, reviewing their output critically, and helping the team establish norms and review standards for agent‑assisted development.
• Reason about API specifications (OpenAPI/Swagger, GraphQL, gRPC) and their downstream implications for generated client code and integrations.
• Write clear tickets, pull requests, and design notes to keep a distributed, asynchronous team aligned.
• Uphold observability, performance, and security best practices across the services you own.

Qualifications

Required (Non‑Negotiable)

• 7+ years of professional software engineering experience with a track record of shipping production systems.
• Expert-level proficiency in a strongly-typed language (e.g., TypeScript, Dart, Kotlin), including strict mode, generics, and complex type inference—with production mobile or web applications delivered, not toy projects.
• Strong backend scripting language skills (e.g., Python, Ruby, Go) with async/await patterns, type annotations, and a solid grasp of schema validation and structured error handling.
• Proficiency with a modern async web framework (e.g., FastAPI, Django Async, Starlette, Express, Hono, Litestar), and comfort with ORM tooling and database migration workflows (e.g., SQLAlchemy/Alembic, Prisma, Drizzle, ActiveRecord).
• Ability to read and reason about API specifications (e.g., OpenAPI/Swagger, GraphQL schemas, gRPC protos) and understand downstream implications for generated client code.
• Auth fundamentals: token-based authentication lifecycle, secure token storage, silent refresh patterns, and why these decisions matter in a healthcare context.
• Self-directed: able to take a feature brief, ask the right clarifying questions, and deliver end‑to‑end without hand‑holding.
• Fluent daily use of AI-powered coding tools—directing agents to scaffold features and reviewing their output critically.
• Strong written communication: works asynchronously with a distributed team and writes clear tickets, PRs, and design notes.

Strongly Preferred

• Monorepo experience using workspace tooling (e.g., pnpm/npm/yarn workspaces, Turborepo, Nx, Bazel), with an understanding of shared packages, dependency graphs, and build caching.
• Attribute-based or role-based access control—especially field‑level, not just route‑level guards.
• In‑memory data store experience (e.g., Redis, Memcached, DynamoDB caching): cache invalidation strategies, key namespacing, and the tradeoffs of caching authorization decisions.
• Observability: structured logging and distributed tracing (e.g., OpenTelemetry, Datadog APM), with a clear sense of what “good” looks like in a production service.
• Cross‑platform mobile deployment across iOS, Android, and web from a single codebase (e.g., React Native, Flutter, Expo), with apps shipped to app stores.

Nice to Have

• Healthcare / health tech background (HIPAA, PHI handling, FHIR)—we’ll teach the domain, but a head start helps.
• LLM application development: streaming responses (SSE/WebSockets), MCP, and tool‑use patterns.
• Experience with LLM orchestration libraries and frameworks (e.g., LangChain, LlamaIndex, Haystack, or comparable tooling) for building production AI features.
• Experience integrating AI coding agents into a team workflow—not just personal use, but establishing norms, review standards, and best practices.

What We Offer

• The opportunity to build core systems at a purpose-driven health tech company at an early, high-impact stage.
• Competitive pay and equity package.
• A flexible, remote-first work environment with an async, distributed team-Future plans to be a Boston metro (likely Burlington/Waltham corridor) hybrid role
• A mission-aligned, collaborative team focused on patient impact.

Join Us

If you’re a builder who ships, works well with autonomy, and wants to use modern tooling—including AI coding agents—to help patients find clarity in the chaos of U.S. healthcare, we’d love to hear from you.