Senior Fullstack Engineer - RCM
Senior Fullstack Engineer - RCM
Posted 2 days ago
SENIORITY
Lead
About the role
- Build screens against our internal component library
- Design and implement API routes contract-first, with schemas shared across frontend and backend
- Model clinical and revenue cycle data in MongoDB, and keep it queryable as collections grow
- Work inside shared TypeScript packages every app in the repo depends onTake features from spec to production and support them once they're live
- Work across the full revenue cycle, from pre-visit clearance through payment
- Integrate with the EHRs and external systems that our clients already run onRequired Qualifications:5+ years building and shipping production web applications, including 3+ years of health care revenue cycle management experience
- Strong TypeScript across the stack
- Hands-on experience with modern front-end framework such as Vue or React
- Backend experience with Node, Express, and MongoDB/Mongoose
- You know what your queries cost. Patient, clinical, and financial data gets large and wide fast, and the difference between a query that scales and one that falls over is usually an index or a schema decision made months earlier
- You can name the shortcomings of the tools you use, not just their features
- You've designed for growth you couldn't fully predict, and can explain what you'd do differently now
- You've worked in a large codebase you didn't write and improved it rather than rewriting itExperience moving health data between systems: HL7, FHIR, EHR connectivity
- You've built complex yet auditable systems geared towards visibility
- Experience processing financial events while effectively managing states for each transaction
- You've created configurable state machines and rule engines that can be easily tweaked to handle new cases with minimal code changes and long term maintenance
- Understanding of how care is delivered: clinical workflow, care pathways, how a patient moves through the system, and how a practice gets paid for itFamiliarity with the OpenAI API or similar LLM tooling
- Monorepo experience (e.g., Turborepo, Nx)
- Realtime or streaming applications
- Durable workflow orchestration (e.g., Temporal, Cadence, AWS Step Functions)
- Experience with cloud platforms such as AWS, Azure, or GCPExperience building analytics or reporting on top of transactional data
- Experience with EDI/X12 (270, 271, 835) is a plus
Before you apply
Applying takes about a minute. These four things decide how fast it moves after that.
Your profile is current
It's what we read first. Occupations, seniority and locations matter more than a long history.
Two examples you can talk through
Not a portfolio — just two pieces of work where you can explain the decisions and what you'd change.
A number in mind
What you're on now and what would make you move. We negotiate better when we know both.
Your notice period
Employers plan around it, and it's the question that stalls offers most often.
Once you apply, someone reads it and calls you before anything reaches the employer — usually within two working days.
