Senior Software Engineer, Virtual Care Platform

About Fabric Health At Fabric Health, we are powering boundless care by solving healthcare’s biggest challenge: clinical capacity. We aren’t here to disrupt healthcare; we’re here to fix it. We unify the care journey from intake to treatment, using intelligent automation to remove administrative burdens and make care delivery 2-10x more efficient. Our technology empowers clinicians to move faster and focus on what matters most: the patient.

We are a mission-driven team of brilliant minds trusted by leading organizations including Intermountain Health, OSF HealthCare, SSM Health, and MUSC Health. Our vision is backed by premier investors such as Thrive Capital, GV (Google Ventures), General Catalyst, and Salesforce Ventures. We move quickly for good reason, listen deeply to solve big challenges, and build products with the same care and quality we’d want for our own loved ones.

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About the Role Step into a pivotal role as the Senior Software Engineer on our Virtual Care Platform, acting as the strategic anchor for our platform's real-world reliability and patient experience. In this high-trust position, you hold the keys to production health, swiftly resolving critical issues while building the tools, automation, and features that make our platform better every day.

Going beyond simply triaging tickets, this role demands true operational engineering. Navigating a large Python/Django monolith and its supporting microservices is essential for fixing complex production bugs, performing precise live-data corrections, and directly protecting patient care. Our platform spans Revenue Cycle Management, eligibility and coverage systems, clinical integrations (e-prescribing, labs, health information exchange), and internal admin tooling, all operating under strict HIPAA requirements. Success also requires dedicating significant time to improving our admin portal, building diagnostic tools, and engineering self-service capabilities that empower our Support, Clinical Operations, and Implementation teams. If you thrive on direct impact, end-to-end autonomy, and building systems that scale, this role offers a high-visibility platform to showcase your problem-solving skills.

What You'll Do As the Senior Software Engineer on the Virtual Care Platform, you own the bridge between Support and Engineering, protecting the core team's focus while keeping patients unblocked. Your primary responsibilities include:

• Serve as the first line of engineering response for incoming production and support issues during business hours, triaging immediately and shielding the core product team from constant interruption.
• Prioritize ruthlessly by patient impact, treating any issue that prevents patients from receiving care, getting prescriptions filled, or having claims processed correctly as critical.
• Diagnose and fix bugs across a large, mature Django codebase and its associated services (Care API, FHIR Facade, COBRA, Dolphins, Health Exchange Handler), moving swiftly from quick corrections to real root-cause changes.
• Make careful, safe live production data edits to resolve urgent issues, including billing corrections, coverage and eligibility fixes, and invoice re-transmissions, maintaining the discipline that patient-facing, HIPAA-regulated systems demand.
• Own and improve the admin portal and internal tooling so Support, Clinical Operations, and Implementations can manage scheduling, eligibility debugging, and billing workflows independently.
• Build documentation, runbooks, and diagnostic tools that empower the broader Support team to resolve common issues on their own over time, leveraging generative AI to rapidly draft technical documentation and troubleshooting guides.
• Partner closely with Support, Clinical Operations, Implementations, and Engineering to turn recurring incidents into permanent fixes rather than repeating fire drills.
• Track patterns across incoming issues, especially around enterprise eligibility, coverage accuracy, billing transmission, and clinical integration errors, feeding them back into the product so the same problems stop recurring.
• Monitor key operational health metrics including enterprise appointment coverage rates, invoice transmission percentages, visit price accuracy, lab processing rates, and SureScripts/e-prescribing error channels.
• Take the lead on our Event Bus initiative, a foundational project to build a Kafka-based (AWS MSK) eventing backbone using CloudEvents and Python.
• Integrate this Event Bus library into the broader platform, define event contracts, and drive adoption across teams.
• Utilize AI coding tools (such as GitHub Copilot, Cursor, or Claude) to accelerate root-cause analysis, script safe data corrections, and streamline your code review process.

Why You Might Be a Good Fit

• You care deeply about the mission and understand that a production bug is not just an inconvenience; it is a patient who cannot get seen, a prescription that cannot be filled, or a claim that is billed incorrectly.
• You run toward the fire, enjoying being first on the urgent issue, triaging fast under pressure, and getting it fixed.
• You possess real depth in Python and Django, comfortably reading and editing a large, live codebase with 60+ apps, multiple databases, Celery task queues, and REST APIs.
• You are a proven diagnostician who moves from symptom to root cause quickly, ensuring you fix the cause rather than just the symptom.
• You take satisfaction in making yourself unnecessary by documenting and building tooling so Support can self-serve and the queue keeps shrinking.
• You are self-directed, comfortable being the solo owner of a domain, setting your own priorities against real urgency, and standing behind your calls.
• You actively incorporate AI tools into your daily engineering workflow to work smarter, debug faster, and automate repetitive tasks.

This Might Not Be The Right Fit If...

• You want to spend most of your time on greenfield roadmap feature work rather than triaging and resolving complex production issues.
• You are primarily a front-end or JavaScript/TypeScript engineer without deep, hands-on Python and Django experience.
• You are uncomfortable making careful live production data changes or participating in on-call coverage.
• You prefer traditional, manual debugging workflows and are resistant to adopting AI-assisted coding and diagnostic tools.

Your Qualifications

• 5+ years of professional software engineering experience, operating at a senior level with a record of owning production systems end to end.
• Deep, hands-on Python and Django expertise, allowing you to navigate and edit a large, mature Django codebase with Django REST Framework APIs, Celery async task processing, and complex ORM queries across multiple databases.
• Proven debugging and production troubleshooting skills, with the composure to work incidents actively affecting patients.
• Experience with relational databases (MySQL and/or PostgreSQL), including comfort writing and optimizing queries and understanding multi-database routing.
• Experience operating production SaaS, ideally multi-tenant, with sound instincts for reliability and safe operational practices.
• Clear written communication skills for documentation, runbooks, and cross-functional collaboration with Support, Clinical Operations, Implementations, and Engineering.
• Comfort operating as a self-directed, solo owner who can set priorities against competing urgency and make the right call.
• Proficiency in using AI development tools to optimize queries, write boilerplate code, and assist in rapid incident response.

Bonus Points

• Experience building software in healthcare or another high-stakes, highly regulated, or safety-critical domain, especially with PHI in a HIPAA environment.
• Experience with Apache Kafka, AWS MSK, or event-driven architectures, including designing event schemas, managing consumer groups, and building reliable eventing pipelines.
• Familiarity with healthcare billing and revenue cycle management (RCM) concepts including claims, eligibility verification, coverage logic, and invoice transmission.
• Experience with healthcare interoperability standards such as HL7 or FHIR, or with health information exchange (HIE) platforms like Particle Health.
• Hands-on experience with ElasticSearch, Redis, RabbitMQ, or Celery in production environments.
• Experience with e-prescribing systems (SureScripts), lab integrations (Quest), or pharmacy workflows.
• TypeScript experience or a willingness to learn it (the team maintains a modern TypeScript microservice utilizing the Hono framework, Bun runtime, and PostgreSQL, deployed on Kubernetes with Helm/Argo Rollouts, and contributions to this service are expected).
• Familiarity with Docker, Kubernetes, AWS infrastructure (S3, Secrets Manager, IAM), and CI/CD pipelines (GitHub Actions).
• Prior experience in a production support, sustaining, or reliability-focused engineering role.

The national pay range for this role is $140,000.00 – $170,000.00 per year. Actual compensation will be determined by factors such as the candidate's geographic market, experience, skills, and qualifications. Certain roles may also be eligible for additional compensation, including a comprehensive benefits package such as medical, dental, vision, unlimited PTO, and a 401(k) plan, stock options and bonuses. If your compensation requirement is greater than our posted range, please still consider applying; a determination can be made based on unique qualifications. Expected compensation ranges for this role may change over time.

At Fabric, we believe that a diverse workforce is essential to our success. We are an equal opportunity employer and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other legally protected characteristic. We actively encourage individuals from all backgrounds to apply.

Recruitment Fraud Alert: Protect Yourself

Fabric Health is aware of scammers attempting to impersonate employers. To ensure that any recruiting contact you receive is legitimate, please adhere to the following:

• Verify the Domain: Official recruitment emails will only come from addresses ending in @fabrichealth.com or @gem.com. No other domain names are legitimate.
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