The Role
Leads enterprise-wide architecture and complex software initiatives across digital pharmacy, fulfillment, and patient-care platforms. Designs scalable distributed systems, high-volume APIs, and reliable data architectures using AWS, PostgreSQL, Ruby on Rails, Python, TypeScript, and JavaScript. Mentors senior engineers, establishes engineering standards, drives performance and security improvements, evaluates technologies, and ensures HIPAA and SOC 2 compliance. Partners with product, engineering, pharmacy operations, and security teams while serving as a technical escalation point.
Summary Generated by Built In
Job Summary
Fuze Health’s foundation is built upon the strategic combination of several proven, technology-powered innovators in the digital health, diagnostics, and pharmacy sectors. Our growing portfolio brings together the capabilities of industry leaders including LetsGetChecked, Truepill, and Alto Pharmacy, to create a distinctive, unified force in healthcare. Together, we have the shared vision, advanced capabilities and talented teams to deliver next-generation solutions that patients and healthcare partners need today and into the future.
Job Description
As a Principal Engineer at Fuze Health/FuzeRx, you are a top-tier technical leader and individual contributor who drives the overarching technical vision and architectural strategy across our engineering organization. Reporting to the VP of Engineering, you will operate across multiple product squads, guiding the design and execution of our most complex, mission-critical systems. By setting the standard for engineering excellence and leveraging our core stack (AWS, PostgreSQL, Ruby on Rails, Python, and TypeScript/JavaScript), you will ensure our digital pharmacy, API-powered fulfillment, and patient care platforms are highly scalable, performant, and secure. This role is essential to our mission, directly enabling FuzeRx to process high volumes of healthcare transactions reliably while maintaining strict compliance and improving patient outcomes.
Key Responsibilities:
- Architectural Vision & Strategy: Define and evolve the target architecture for FuzeRx’s core B2B and consumer platforms. Drive the technical roadmap to transition legacy systems into modern, scalable, and highly cohesive architectures.
- Complex Problem Solving: Lead the design and implementation of the most technically challenging initiatives, such as high-volume API integrations, complex pharmacy fulfillment logistics, and distributed data consistency.
- Technical Mentorship & Leadership: Serve as a mentor and force multiplier for Staff, Senior, and Mid-level engineers. Elevate the engineering culture by instituting rigorous design reviews, pairing sessions, and technical brown-bags.
- Standards & Best Practices: Establish and enforce engineering standards across the organization, including coding guidelines, testing frameworks, CI/CD pipeline strategies, and security-by-design principles.
- Cross-Functional Partnership: Collaborate deeply with Product Management, Engineering Managers, and Pharmacy Operations to ensure technical architectures align with long-term business goals and clinical requirements.
- Regulatory & Security Compliance: Partner with the InfoSec team to architect systems that natively support strict healthcare compliance standards (HIPAA, SOC2), ensuring patient data privacy and secure messaging.
- Performance & Reliability: Spearhead initiatives to optimize system performance, reduce latency, and improve database efficiency within our PostgreSQL and AWS infrastructure.
- Technology Evaluation: Continuously evaluate new tools, frameworks, and AWS services, running proof-of-concepts (POCs) to determine their viability for improving the FuzeRx ecosystem.
- Education: Bachelor’s degree in Computer Science, Software Engineering, or a related technical discipline.
- Experience: 10+ years of progressive, hands-on experience in software engineering and systems design. 3+ years operating at a Staff, Principal, or equivalent senior architectural level, driving technical initiatives across multiple teams.
- Industry Experience: Extensive background in building and scaling distributed, high-throughput, and highly available B2B SaaS or transactional systems.
- Shift / Site Specific Requirements: Standard business hours; expected to serve as a Tier 1 technical escalation point for critical architectural outages. [Insert Remote/Hybrid/On-site details].
- Tools & Tech Stack: Mastery of modern cloud architectures and demonstrable, deep, hands-on expertise in AWS, PostgreSQL, Ruby on Rails, Python, TypeScript, and JavaScript. Familiarity with standard corporate tools (Slack, GSuite, Jira).
- Other Desired Experience: Exceptional communication skills with the ability to explain complex technical trade-offs to non-technical executives and stakeholders. A strong bias for action and pragmatism over architectural purity.
- Measurable Expertise: Proven ability to design and implement complex distributed systems, optimize complex relational database queries, and establish automated deployment pipelines.
- Education: Master’s degree in Computer Science, System Engineering, or related field.
- Other Desired Experience: Active contributions to the open-source community or experience speaking at technology conferences.
- Specific Required Expertise: Deep domain expertise in HealthTech, Digital Pharmacy, or highly regulated environments.
- Advanced knowledge of healthcare data interoperability standards (e.g., HL7, FHIR, NCPDP) and electronic health record (EHR) integrations.
- Experience leading a major architectural paradigm shift (e.g., monolith to microservices or event-driven architecture) at scale.
- FuzeRx (Truepill / Fuze Care Services) is limited to individuals residing in the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin.
At Fuze Health, we are committed to fostering an inclusive environment that celebrates diversity in all its forms. We believe that the diversity of thought, background, and experience strengthens our teams and drives innovation. We are an equal-opportunity employer and do not discriminate on the basis of race, ethnicity, religion, color, place of birth, sex, gender identity or expression, sexual orientation, age, marital status, military service status, or disability status. Our goal is to ensure that everyone feels valued and empowered to thrive.
Fuze Corporate Inc. and its subsidiaries respects your privacy and is committed to protecting your personal information. Please read our Candidate Privacy Notice which explains how we collect, use, disclose, and protect personal information about job applicants during the recruitment and hiring process.
Fuze Corporate Inc. and its subsidiaries respects your privacy and is committed to protecting your personal information. Please read our Candidate Privacy Notice which explains how we collect, use, disclose, and protect personal information about job applicants during the recruitment and hiring process.
Security Notice: Individuals are impersonating Fuze Health recruiters and executives. Verify all communications originated from @fuzehealth.com.Learn more here
Additional Information
#LI-Remote
Equal Opportunity Employer
Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at [email protected].
Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.
Use of Automated Decision Tools
Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us at [email protected].
Privacy Notice
To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants.
Skills Required
- Bachelor's degree in Computer Science, Software Engineering, or a related technical discipline
- 10+ years of progressive, hands-on software engineering and systems design experience
- 3+ years at Staff, Principal, or equivalent senior architectural level, driving initiatives across multiple teams
- Experience building and scaling distributed, high-throughput, highly available B2B SaaS or transactional systems
- Deep hands-on expertise in AWS, PostgreSQL, Ruby on Rails, Python, TypeScript, and JavaScript
- Ability to design complex distributed systems, optimize relational database queries, and establish automated deployment pipelines
- Exceptional communication skills and ability to explain technical trade-offs to executives and stakeholders
- Master's degree in Computer Science, Systems Engineering, or a related field
- Open-source contributions or technology conference speaking experience
- Deep expertise in HealthTech, digital pharmacy, or highly regulated environments
- Knowledge of HL7, FHIR, NCPDP, and EHR integrations
- Experience leading major architectural shifts, such as monolith-to-microservices or event-driven architecture
- Authorization to work for any U.S. employer without visa sponsorship
Alto Pharmacy Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Alto Pharmacy and has not been reviewed or approved by Alto Pharmacy.
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Healthcare Strength — Healthcare coverage is described as comprehensive, with medical, dental, and vision plans available from the first day of employment. This breadth is also reinforced by references to insurance being available for full-time employees.
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Leave & Time Off Breadth — Time off is positioned as generous, with paid time off and bereavement pay explicitly cited. This signals that non-wage rewards are part of the overall package for eligible roles.
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Retirement Support — Retirement benefits are presented as available through a 401(k), with mentions of stock-related opportunities in some roles. This adds a longer-term savings component to total rewards for those who qualify.
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The Company
What We Do
Alto is America’s leading digital pharmacy, transforming a $500 billion industry. Founded in 2015, Alto’s better pharmacy model is centered on the critical role of pharmacists as the final link in a person’s health journey. Alto combines expert pharmacist care with purpose-built technology to deliver a more convenient and affordable experience for those who need medication. To date, Alto has fulfilled more than three million prescriptions, expanded to twelve markets, and built a mobile app experience that makes it easier than ever to manage medications and chat with a pharmacist. As Alto continues its rapid growth, it remains customer obsessed, with an industry-leading NPS score of 86.
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