Senior Software Engineer / Architect

FamilyWell Health is an AI-enabled mental health start-up dedicated to solving the women’s mental health crisis by seamlessly embedding high quality, equitable, & affordable mental health care into OB/Gyn practices. FamilyWell provides comprehensive virtual mental health services designed specifically for integration into OB/Gyn practices utilizing the psychiatric collaborative care model. FamilyWell’s virtual care team model delivers evidence-based coaching, therapy, care coordination, and psychiatric services with specialized expertise in perinatal mental health and perimenopause/menopause.

FamilyWell is scaling a tech-enabled mental health platform for women. Our custom Registry (Postgres) orchestrates care across our EMR (Healthie), Spruce messaging, RCM, and patient engagement tools. Next up: a BI layer, data warehouse, and workflow automation. We’re hiring a hands-on senior engineer who owns the whole stack—design it, build it, instrument it, secure it—while partnering on system design, reliability, and data architecture.

• Platform & architecture
• Define and evolve our system architecture (service boundaries, data model, integration strategy, security/identity).
• Choose the right patterns (events/queues, caching, REST/FHIR/GraphQL contracts) and document them clearly.
• Create reference implementations and guardrails (linting, testing, codegen, libraries).
• Product engineering
• Lead development of Registry features: care-team workflows, scheduling, cohorting, rules/automation, and patient program logic.
• Build and maintain integrations with Healthie, Spruce, Slack, Google Workspace, RCM, and data/BI tools; design for idempotency, retries, and reconciliation.
• Data & reliability
• Own all schema design, migrations, and performance; set patterns for read replicas and CDC to the data warehouse (Snowflake).
• Mature observability (metrics, logs, traces), SLOs, and error budgets; drive incident response.
• Security & compliance
• Champion HIPAA/SOC 2 best practices: PHI handling, audit logging, least-privilege, encryption, key rotation, SSO (SAML/OIDC).
• Partner with ops/compliance on evidence collection and vendor risk reviews.
• DevOps & delivery
• Shape CI/CD, infrastructure-as-code, environment strategy, and release practices; guide cost/perf tradeoffs.
• Establish SDLC rituals (PR review, ADRs, release notes) and quality bars (unit/integration/e2e).
• Technical leadership
  
• Be the technical owner for the platform; mentor engineers; collaborate tightly with Product, Data, and Clinical Ops; translate requirements into clear technical plans.

• Backend: TypeScript/Node (or Python), Postgres (SQL, indexing, EXPLAIN), Redis, queues (SQS/Kafka/Rabbit)
• APIs/Interop: REST, webhooks, OAuth2, SAML/OIDC; familiarity with FHIR/HL7, X12 (RCM) is a plus
• Frontend: React/Next.js (Vercel), Tailwind (nice to have)
• Infra: AWS or GCP, Fly.io/Vercel, Docker, Terraform (or Pulumi), CI/CD (GitHub Actions)
• Data: CDC (Debezium/Logical Replication), dbt, Snowflake/BigQuery (with an Analytics/BI Eng partner)
• Obs/Sec: Datadog/CloudWatch, OpenTelemetry, Vault/KMS, SAST/DAST
  

• 7–10+ years building production systems; 3+ years owning architecture or complex service design.
• Shipped secure, reliable systems in healthcare or another regulated space; comfort with HIPAA.
• Led integrations with 3rd-party SaaS/EMRs; handled idempotency, rate limits, retries, reconciliation.
• Scaled Postgres (schemas, migrations, vacuum/ANALYZE, partitioning, read replicas).
• Proven track record of turning ambiguous requirements into shipping software on tight timelines.
• Excellent code quality, testing discipline (unit/integration/e2e), and documentation habits.
  

• Experience with Healthie, Spruce, athenahealth, Canvas, or RCM systems.
• Event-driven architectures; rules engines or workflow orchestration (Temporal/Cadence).
• Security certifications or SOC 2 audit experience.
• Prior startup, 0→1 and 1→n scaling.