Fullstack Engineer

Fullstack Engineer

Full time

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New York, New York | Hybrid

4 - 10 Years of Experience

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Who is Recruiting from Scratch:

Recruiting from Scratch is a premier talent firm that focuses on placing the best product managers, software, and hardware talent at innovative companies. Our team is 100% remote and we work with teams across the United States to help them hire.

Full-Stack Software Engineer

Location

New York, NY / San Francisco, CA

Work Arrangement: Hybrid — 3 days in-office per week Position: Full-time Company Stage: Series A Experience: Experienced software engineer; see recruiter notes on the experience range Compensation: $160,000–$200,000 base salary + competitive equity Benefits: Not specified Visa Sponsorship: Not available. Candidates must already be authorized to work in the U.S. without sponsorship.

Company Description

We are building an AI-powered operating system for healthcare providers, helping clinicians start, run, and scale their practices while reducing the administrative complexity that takes time away from patient care.

The platform brings together billing, payroll, scheduling, clinical documentation, parent communication, and other essential business operations into one integrated system. By combining modern software with autonomous AI agents, we are rethinking how healthcare practices operate.

The business has grown rapidly, reaching $2M in revenue within eight months and growing approximately 30% month over month. Following a recent $10M Series A, the company is expanding its engineering team to support its growing customer base and build the platform foundations needed for its next stage.

You'll join a small engineering team where you will have meaningful ownership over core systems, architecture, and product development. This is an opportunity to work across complex backend systems, AI infrastructure, financial workflows, and user-facing products.

What You Will Do

Own core platform systems: Design and build foundational systems, including data models, APIs, state machines, business logic, and production infrastructure.

Build AI-native clinical workflows: Develop AI-powered products that support clinical documentation, treatment planning, reassessments, supervision, and administrative work.

Build revenue and payment infrastructure: Develop systems for service authorizations, billing, payment adjudication, and provider payouts, ensuring accuracy and reliability.

Develop provider business operations: Build tools that simplify credentialing, contracting, compliance, payroll, scheduling, and staffing.

Improve patient and family experiences: Build products supporting intake, onboarding, scheduling, communication, progress tracking, and payments.

Automate internal operations: Develop software and AI systems that automate manual workflows across billing, authorizations, credentialing, and care coordination.

Own features end to end: Work across backend services, database schemas, APIs, and frontend experiences to deliver complete product functionality.

Make architectural decisions: Establish reliable data models, enforce business rules, design state machines, and build systems that can scale with the business.

Work across the stack: Contribute to backend-heavy projects while remaining comfortable working on frontend functionality and product experiences.

Use AI in development: Incorporate AI tools into your daily engineering workflow and identify opportunities to use AI to improve both development and operational processes.

Maintain production quality: Take responsibility for reliability, data integrity, security, and the accuracy of systems that support important business operations.

Ideal Candidate Background

Required Experience

Professional software engineering experience building and maintaining production systems.

Strong proficiency in Python. Python is a non-negotiable requirement for this role.

Strong backend engineering experience, with the ability to design and own complex systems.

Experience working with databases, data models, APIs, and application architecture.

Ability to take ownership of projects and drive them independently with minimal coaching.

Experience building systems where accuracy, reliability, and data integrity are important.

Strong problem-solving skills and the ability to work through complex business logic and operational edge cases.

Experience working in fast-paced environments with a high engineering bar.

Strong attention to detail and a consistent track record of delivering high-quality work.

Comfortable working across backend and frontend systems as needed.

Ability to work from the New York or San Francisco office at least three days per week.

Must already be authorized to work in the United States without visa sponsorship.

Technical Skills

Core Engineering

Python backend development.

Backend architecture and system design.

API development and integrations.

Database design and data modeling.

Business logic and state management.

Production systems and reliability.

Full-stack product engineering.

Relevant Technologies

Backend: Python.

Databases: NoSQL, MongoDB, Firebase.

Architecture: Domain modeling, state machines, system design.

AI: AI agents, LLM-powered workflows, AI-native product development.

Product: Clinical workflows, financial systems, operational automation.

Python is essential. Experience with NoSQL databases, particularly MongoDB or Firebase, is preferred. Candidates do not need experience with every technology listed, but should demonstrate strong backend fundamentals and the ability to own complex production systems.

Preferred Background

Experience at high-performing fintech or healthcare technology companies.

Experience building systems involving financial transactions, payments, billing, or payroll.

Experience in healthcare, insurance, logistics, or other operationally complex industries.

Experience with MongoDB, Firebase, or other NoSQL databases.

Experience building AI-powered products or integrating LLMs into production workflows.

Experience designing state machines, domain models, and systems with complex business rules.

Experience working with data-sensitive or high-accuracy systems.

Experience working in small, high-performing engineering teams.

Experience taking ownership of projects with limited supervision.

Experience building products from early stages and scaling them as the business grows.

Working Style and Culture

High ownership: Takes responsibility for important systems and drives projects through completion.

Systems-oriented: Naturally thinks about data models, state transitions, business rules, and edge cases.

Detail-oriented: Understands that small mistakes in financial or healthcare systems can have significant consequences.

Independent: Comfortable making decisions and moving projects forward without constant direction.

Product-minded: Understands user problems and builds software that solves practical operational challenges.

AI-native: Actively uses AI tools and is interested in building AI-powered workflows.

Adaptable: Comfortable moving between architecture, backend implementation, product development, and debugging.

Pragmatic: Balances speed with sound technical judgment and long-term maintainability.

Curious: Enjoys learning complicated domains and understanding how businesses operate.

Hands-on: Enjoys writing code and building systems rather than focusing primarily on management.

Compensation and Benefits

Base salary: $160,000–$200,000.

Equity: Competitive equity; specific details to be confirmed.

Work arrangement: Hybrid, with at least 3 days per week in the office.

Locations: New York City or San Francisco.

Visa sponsorship: Not available.

Why Join?

Build foundational systems: Own critical platform architecture and business logic at an important stage of company growth.

Work on meaningful AI products: Build AI-powered workflows that reduce administrative work and help healthcare providers focus on patient care.

Have real ownership: Take responsibility for systems that directly affect the company's operations and ability to scale.

Solve complex engineering problems: Work on financial systems, payments, clinical workflows, data models, and AI infrastructure.

Join a growing company: Be part of a business that has reached $2M in revenue within eight months and is growing rapidly.

Work with a small team: Have meaningful influence over technical decisions and product development.

Build for real-world impact: Help improve the operational infrastructure supporting healthcare providers and the families they serve.

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