Senior Software Engineer

ABOUT US Medical data exchange is one of the biggest unsolved problems in US healthcare. If you've spent any real time in the healthcare system, you've felt it, and it only gets worse the sicker and older you get. Metriport exists to fix that. We connect to the data sources the healthcare providers of tomorrow need, take raw data that's unusable in its source form, and turn it into a single clean format that care teams, and their agents, actually use to improve outcomes. Record retrieval across thousands of legacy systems and antiquated data pipes that used to take weeks now takes seconds. Clinicians walk into appointments with the full patient picture already in hand, and that speed can mean spotting a condition early enough to actually treat it. We're not a healthcare company. We're a technology company that happens to operate in healthcare, and we build every layer ourselves: connect, transform, and insight. Legacy EHRs were built to get providers paid, not to serve the clinical experience. We're building what should have existed instead: the system of record for all of US healthcare. We started in data exchange. Today we compete with the largest data platforms in the space. Tomorrow we will be the infrastructure layer healthcare runs on. We’ve raised $28.4 million from top-tier VCs (including Matrix, ARTIS and Y Combinator), found product-market fit (multi-million dollar ARR, 100+ customers including Amazon One Medical, Circle Medical, Color Health, and Strive Health), and have years of runway ahead of us. If you’ve had a good healthcare experience in the past few years, there’s a good chance Metriport was behind it. That’s the version of healthcare we want people to not just expect, but demand. Join us and build the future. About You We're a small, high-output team, mostly former founders including YC alumni, and we operate with real autonomy and almost no bureaucracy. We hire on competence, not pedigree. Leaders are in the office six days a week, and we generally expect the team to be available six days a week too. Not because we count hours, but because there's always more wood to chop when revolutionizing how tomorrow’s healthcare providers deliver care to their patients today. We trust our team to take the time off they need and we've never said no to a time off request. You have an entrepreneurial mindset and a strong sense of ownership. You don't wait to be told what's broken. Instead, you believe you can figure out any problem that lands in your lap even outside your exact domain. When someone scopes something for three weeks, you ask why it can't be done in three days, and you also know the difference between shipping a fast v0 and cutting a corner that comes back to bite you. You walk the tightrope between craft and speed without falling off either side. THE ROLE We're looking for "generalist" engineers who can operate at a Senior level: - You're confident in building scalable, distributed systems across the full stack — with particular depth on the back-end — and people usually come to you for technical guidance. - You fully own your work — technical decisions, delivery, results — and you level up the engineers around you through code reviews, pairing, and guidance. Multiplying the team's output energizes you as much as shipping your own. - You're entrepreneurial-minded with an olympian-level work ethic (about half our engineering team are former founders). - You understand reliability, security, and networking end-to-end — designing for uptime, thinking like an attacker to harden your systems, and diving into the network layer yourself rather than treating it as someone else's domain. - You care about delivering value to customers, not about what frilly new tech is under the hood. - When someone scopes a project for 3 weeks, you ask "why can't it be done in 3 days?" — and you help others develop that same instinct. - You're a hacker at heart, with a good sense of which rules should, and shouldn't, be broken. WHAT YOU'LL BE DOING We ingest clinical data for millions of patients from external healthcare sources, with continuous updates for a growing subset of those patients. You'll be a catalyst to scale the platform that powers our product — and ship it to customers fast. Day to day, that looks like: - Raising the technical bar: applying and improving our patterns for low-latency, highly scalable, event-based systems integrations; championing observability into every part of the platform you touch; writing maintainable code that sets the example for others; and making effective use of AI in our product (evals, harnesses, observability). - Working across our back-end-heavy platform: our public API (the core product our customers build on), integrations with health information networks (Carequality, CommonWell, eHealth Exchange) and third parties (EHRs, data vendors, partner platforms), and the platform work that lets the rest of the team ship faster. - Driving projects end-to-end, from ideation to production rollout: writing Design Documents, shipping v0's quickly, and iterating to v1 and beyond. - Multiplying the team: mentoring engineers, reviewing designs and PRs, judging when to invest in quality vs. ship fast, and improving our dev processes and tooling so quality and security are enforced by default. - Participating in bi-weekly sprint planning and retros, joining our daily 30-min remote stand-up at 7:30am PST (our only mandatory meeting), and taking part in the on-call rotation. Example projects you could own: - Refactoring our core data pipeline to process data 10x faster than originally designed. - Using AI/ML to turn freeform doctors' notes into structured data we can add to patients' medical records. - Identifying the biggest infra cost opportunities and shipping the changes — saving money while increasing scalability. - Transforming incoming TCP messages from hospitals using a 90s-era protocol into modern HTTP webhooks routed to our customers. - Leveling up developer experience: making systems easier to test, tightening CI/CD, and cutting the time from PR to production. REQUIREMENTS - 6+ years as a full-stack engineer, with a heavy lean towards back-end — public APIs, distributed systems, and complex integrations with external systems. - Experience developing, maintaining, and scaling cloud-based platforms to many millions or billions of transactions a day — including optimizing architecture and code for scalability and cost. - Experience mentoring or guiding other engineers — through code reviews, pairing, design feedback, or onboarding. - You've made engineering teams faster — better developer experience, more testability, shorter release cycles — and you can talk about the before/after. - You’re located in San Francisco or the Bay Area (or willing to relocate). - Bonus: - Experience processing large amounts of data, including moving it across different services, transforming/consolidating, and building services to query it. - Healthcare standards/technologies: FHIR, HIE, IHE, EHR/EMR, NPI, TEFCA, ADT, HL7, HEDIS, RAF, SNOMED, LOINC, ICD-10, etc. BENEFITS - Competitive equity + compensation package 🚀 - Full family Platinum health insurance, dental, and vision coverage 🦷 - 401(k) retirement plan + matching 💰 - Flexible work from home or in-office 🏢 - Healthy lunches are complimentary when working in-office (and breakfast + dinners as needed) 🍏 - Quarterly company off-sites with the team ⛷️ - MacBook provided by us 💻 - Unlimited PTO (we work hard, but trust you to take time you need to be at your best) 🧘‍♂️ OUR TECH Core business logic in Node.js and TypeScript, with Python in data and ML workflows. AWS across the board (ECS, Lambda, SQS, SNS, Batch, etc.), infrastructure as code with CDK. Data lives in S3, PostgreSQL/Aurora, DynamoDB, Snowflake, and our FHIR server — with Athena for querying S3 and SageMaker for ML. The ideal person for this role is a generalist who picks the best tool for the job. Metriport provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, sexual orientation, gender identity, or gender expression. We are committed to a diverse and inclusive workforce and welcome people from all backgrounds, experiences, perspectives, and abilities.