Senior Full Stack Engineer - HealthTech

Location: U.S. Remote
Compensation: $190K-$200K base + bonus + equity
Schedule: Flexible hours with PST overlap
Travel: None

Build healthcare systems with real operational impact

We are hiring a Senior Full Stack Engineer to build and improve the systems that power critical healthcare workflows.

This is a senior individual-contributor role on a lean engineering team. You will work directly with product and leadership, own meaningful systems end-to-end, and help shape the technical plan behind them.

There are no direct reports. We are looking for someone who can move beyond ticket execution: understand the broader system, explain technical tradeoffs, and turn ambiguous problems into practical plans.

Our tools are primarily used by internal healthcare operations teams, supporting workflows tied to hundreds of thousands of patient visits each year.

What you'll do

• Build and operate production applications, APIs, integrations, data workflows, and internal user experiences.
• Work across a polyglot stack that includes Ruby on Rails, Python, Node.js, SQL, and adjacent services.
• Design reliable systems for sensitive healthcare data, with attention to data quality, auditability, performance, concurrency, and failure handling.
• Own features from problem definition through launch, production support, and iteration.
• Partner directly with product and leadership to define milestones, surface tradeoffs, and improve engineering standards.
• Improve delivery, CI/CD, observability, and operational reliability alongside feature development.
• Use AI coding tools such as Claude Code, Cursor, or Codex to accelerate delivery while maintaining strong testing and review practices.

What you bring

• 7+ years building and operating production software, or equivalent Senior-level scope.
• Strong hands-on experience in Ruby on Rails or Python, plus the ability to work confidently across multiple languages and systems.
• Strong SQL and data-modeling skills, including PostgreSQL or similar relational databases.
• Experience with JavaScript/TypeScript and modern web application development.
• Strong engineering fundamentals: data structures, complexity, concurrency, API design, testing, and systems design.
• Experience building reliable integrations, data pipelines, or high-volume operational systems.
• Working knowledge of DevOps practices, including CI/CD, Docker, cloud infrastructure, monitoring, and incident response.
• Clear examples of using AI coding agents responsibly, including how you validate their output.
• A computer science degree or equivalent foundation in core software-engineering principles.
• U.S. work authorization without sponsorship.

Nice to have

• Healthcare, regulated-data, insurance, or operations-platform experience.
• Experience with AWS, Kubernetes, event-driven systems, or distributed services.
• Experience with C#, analytics systems, or data-warehouse tooling.
• Experience improving and scaling systems already in production.

Benefits

• Health, dental, and vision insurance
• 401(k)
• Generous PTO
• Direct access to leadership and fast decision-making
• Fully remote work with flexible hours
• Modern, AI-assisted engineering workflows

At Urrly, fairness matters. We use AI to review every application against the same clear requirements for the role. Candidates are evaluated only on job-related factors such as skills, certifications, and experience, not personal attributes.