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Staff API Engineer, Ruby on Rails

Remote

We’re building infrastructure for modern healthcare delivery

Traditional healthcare is plagued with outdated, monolithic EHRs designed to maximize billing outcomes. Patient outcomes and provider experiences have been afterthoughts, as these systems have bolted on non-API-first solutions. None of this is built for how clinically excellent healthcare is actually delivered—longitudinally and collaboratively, with the patient at the center.

Healthie is the world’s leading API-first, ONC-Certified EHR for healthcare delivery outside of the hospital. We provide the powerful infrastructure every scaling organization needs—EHR, scheduling, patient engagement, billing, and more—all accessible via modern APIs and a white-labeled UI. Our platform makes it simple for organizations of any size to launch, customize, and scale their care delivery models without reinventing the wheel.

Today, over 1 billion API calls are made to Healthie every month, as thousands of organizations—working with more than 13 million patients in total—rely on Healthie to deliver care across a spectrum of specialties, from preventative health and wellness to complex chronic care management.

We believe in the power of technology to improve access to healthcare—and we’re building the rails that make this a reality. We work fast and with quality because we provide business-critical, healthcare-critical software that clinicians and patients need for a better healthcare system. We’re customer-obsessed, operate with lightning-fast processes and responses, make our product roadmap public so customers can see what we’re building, and remain relentlessly focused on how care gets delivered.

Healthie is backed by leading investors, and while we've $42M raised to date, more importantly, we operate with fiscal responsibility and have been profitable for more than half of our time as a company.

Learn more at https://www.gethealthie.com/

About the role

We’re seeking a Staff Software Engineer, API to help define and scale the backbone of Healthie’s platform. In this role, you’ll leverage deep Ruby on Rails expertise to architect, optimize, and evolve the core systems that power our API-first ecosystem.

Our API already processes over 1 billion calls each month—enabling thousands of developers to build custom integrations, analytics, and patient experiences. You’ll ensure our Rails-powered systems scale with ease, while also guiding the evolution of our GraphQL API. Think of this as a chance to bring your Rails mastery to bear on one of healthcare’s most exciting technical challenges—while also growing into an API leader who sets the standard for performance, reliability, and developer experience.

This is a Staff-level role: you’ll mentor engineers, influence architecture across teams, and set the technical vision for how Healthie’s API grows alongside our rapidly expanding developer community.

Details, details

  • This is a full-time, remote position located in the United States
  • The base salary for this role is $197,000-$227,000 per year plus equity & company bonus, benefits
  • U.S. work authorization is required and Healthie does not provide sponsorship.

What You'll Do

  • Architect and evolve Rails-based systems that underpin our API platform—ensuring scalability, maintainability, and reliability.
  • Guide the next phase of our GraphQL API, contributing Rails expertise while deepening your impact on API design and ergonomics.
  • Drive backend performance initiatives—from query optimization to scaling strategies—so our systems handle billions of calls seamlessly.
  • Build and refine internal frameworks and developer tools that enable teams to ship faster and more consistently.
  • Partner with product and engineering leadership to shape the API roadmap, aligning technical vision with developer and customer needs.
  • Mentor engineers, conduct technical reviews, and champion architectural best practices across teams.
  • Improve observability, monitoring, and debugging tools to keep our platform rock-solid as we scale.

About You

  • 8+ years of backend engineering experience, with deep Ruby on Rails expertise.
  • Proven experience designing and scaling large, complex backend systems—monolithic or hybrid.
  • Strong foundation in database design and scaling: schema evolution, query optimization, sharding, migrations.
  • Experience building shared frameworks, libraries, or SDKs that accelerate developer velocity.
  • Excited to grow expertise in GraphQL—or already bringing exposure and enthusiasm for APIs at scale.
  • Comfortable navigating legacy code and incrementally modernizing it to meet today’s performance and reliability needs.
  • A mentor and technical leader who elevates others and sets high engineering standards.
  • You’re passionate about developer experience, reliability, and performance—and about improving healthcare through technology.
  • Strong communication skills and a collaborative mindset — you enjoy helping other teams succeed
  • You embody Healthie’s core values of Respect, Reliability, and Resilience, and integrate them into your engineering work, decision-making, and team collaboration.

Interview Process

  • Interview with Katie, Director of Talent (20 minutes)
  • Interview with Sherilyn, Engineering Manager for Platform (30 minutes)
  • Take Home Assessment - completed asynchronously
  • Technical Interview with Andrew and Chris, Engineers for Platform (1 hour)
  • Leadership Interviews:
    • Interview with John, Director, Engineering (30 minutes)
    • Behavioral Executive Interview with Cavan, CTO + cofounder- (20 minutes)
  • Reference checks

To learn more about Working at Healthie & our benefits, click here.

Healthie participates in e-verify

Healthie is committed to equal employment opportunity. All qualified applicants will receive consideration for employment without regard to and will not be discriminated against based on age, race, gender, color, religion, national origin, sexual orientation, gender identity, veteran status, disability or any other protected category. We're proud to be building a diverse and inclusive environment that encourages collaboration, creativity, and growth. Whatever your background, please apply if this is a role that would make you excited to come into work every day. 

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