Staff Software Engineer

Summary

Join Thoughtful's mission to revolutionize healthcare with their AI-powered Revenue Cycle Automation platform. As a Staff Software Engineer, you will drive the architecture and implementation of robust, secure, and scalable systems integrating with Epic's APIs and other healthcare interoperability standards. You will collaborate with product and engineering teams to enable high-fidelity data exchange and real-time automations. This role involves building healthcare-grade integrations, owning the backend stack, driving infrastructure and observability, and collaborating cross-functionally. You will also mentor other engineers and contribute to a positive and impactful work environment. Thoughtful offers competitive compensation, equity participation, health benefits, and generous time off policies.

Requirements

• Software Engineer Experience: 8-10+ years of relevant experience
• Epic Experience: Hands-on experience integrating with Epic via FHIR APIs, HL7v2, Interconnect , or Bridges . Comfortable debugging workflows involving ADT , Orders , or Scheduling
• Backend Systems Expertise: Proficient in Python (FastAPI preferred), Node.js, or Go. Strong API design skills including idempotency, pagination, error handling, and versioning
• Security and Compliance Mindset: Deep understanding of HIPAA, audit logging, and OAuth2 authorization flows (including Epic’s App Orchard or vendor sandbox patterns)
• Cloud and Infra: Experience deploying and scaling microservices in cloud environments (preferably AWS), with infrastructure-as-code (Terraform a plus)
• Data Storage & Pipelines: Comfortable designing schemas and queries across PostgreSQL and/or DynamoDB. Familiar with processing batch and streaming data securely and efficiently
• Testing & CI/CD: Builds with quality from the start - writes unit, integration, and smoke tests and contributes to CI/CD pipelines

Responsibilities

• Build Healthcare-Grade Integrations: Lead the development of scalable backend services that interface with Epic using FHIR, HL7v2, and Epic’s proprietary APIs. Ensure compliance with security, privacy, and interoperability standards
• Own the Backend Stack: Design and implement modular services that support data pipelines, job orchestration, real-time event handling, and long-running workflows, all tuned for the realities of healthcare data
• Drive Infrastructure and Observability: Contribute to the design of our AWS-based infrastructure. Champion monitoring, alerting, and traceability to ensure reliability and fast issue resolution for critical integrations
• Collaborate Cross-Functionally: Work alongside product managers, clinical operations, and other engineers to deeply understand customer workflows and translate them into robust system behaviors
• Mentor and Unblock: Provide architectural guidance and technical leadership to other engineers, particularly around integration patterns, authentication strategies, and system reliability

Preferred Qualifications

• You’ve built production systems that exchange data with EHRs and understand the quirks and edge cases of real-world healthcare data
• You bring strong systems thinking and can design for failure, latency, and observability from day one
• You’ve worked in fast-paced, highly regulated environments and are pragmatic about trade-offs between velocity and stability
• You know that good documentation and clean interfaces are just as critical as performant code
• You’re motivated by impact, not titles, and you bring others along for the ride

Benefits

• Competitive compensation
• Equity participation: Employee Stock Options
• Health benefits: Comprehensive medical, dental, and vision insurance
• Time off: Generous leave policies and paid company holidays