Principal Engineer

Alto Pharmacy

California (MO)

Hybrid

USD 210,000 - 262,000

Full time

12 days ago

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Benefits offered by this job

Dental

Vision

401(k) retirement plan

Group medical plans

Life insurance

STD/LTD insurance

FSA/HSA

Commuter benefits

Paid holidays

Job summary

Fuze Health is seeking a Principal Engineer to set the architectural direction for FuzeRx and related platforms. You will guide multi-squad engineering efforts, shape the technology stack (AWS, PostgreSQL, Ruby on Rails, Python, TypeScript/JavaScript) for scalable, secure healthcare solutions, and collaborate with product, operations, and security teams to meet stringent regulatory requirements.

You will mentor engineers, drive design reviews, and push for high-quality, reliable delivery across

Qualifications

Bachelor's degree in Computer Science, Software Engineering, or a related technical discipline.
10+ years of progressive software engineering and systems design experience.
3+ years at Staff/Principal or equivalent senior architectural level.
Extensive background in building and scaling distributed, high-throughput B2B SaaS or transactional systems.

Responsibilities

Architectural Vision & Strategy: Define and evolve target architecture for core platforms; drive the technical roadmap.
Complex Problem Solving: Lead design and implementation of high-volume API integrations and complex fulfillment logistics.
Technical Mentorship & Leadership: Guide Staff, Senior, and Mid-level engineers and enforce design reviews.
Standards & Best Practices: Establish engineering standards including CI/CD and security-by-design.
Cross-Functional Partnership: Align architectures with Product, Engineering Managers, and Pharmacy Ops.
Regulatory & Security Compliance: Ensure systems meet HIPAA/SOC2 requirements.
Performance & Reliability: Optimize performance and database efficiency in PostgreSQL and AWS.
Technology Evaluation: Assess new tools and AWS services with POCs.

Skills

Architectural vision

Complex problem solving

Staff/Principal leadership

Communication to executives

Education

Bachelor's degree in CS/SE

Tools

AWS

PostgreSQL

Ruby on Rails

Python

TypeScript/JavaScript

Job description

Job Summary

At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments - and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs. 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.

Required Experience & Qualifications

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.

Preferred Qualifications

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.

Physical Requirements

Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions. Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Fuze Health’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.

Salary Range

$209,600 - $262,000

Location Requirement

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.

Employment Authorization Requirement

Applicants must be authorized to work for any employer in the U.S. Alto Pharmacy, Fuze Health, LetsGetChecked, and Fuze Care Services can not take over, transfer, or sponsor any visa type at this time.

Benefits

dental
vision
multiple group medical plans to choose from
a 401(k) retirement savings plan
group life insurance
accidental death and dismemberment (AD&D) insurance
flexible spending account (FSA) and health savings account (HSA)
commuter benefits
employer-paid short-term (STD) and long-term disability (LTD) insurance
additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program)
flexible vacation time
accrued paid sick time
10 paid holidays
(2 floating holidays for full time non-exempt employees)
eight weeks of paid parental leave for eligible employees
additional paid weeks for the birthing parent
4 weeks paid caregiver leave
a Lifestyle Spending Account allowance each month

More Benefits Information Here: Fuze Health Benefits Site

Equality & Inclusion

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.

Equal Opportunity Statement

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.

Accommodation Statement

If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com.

Background Check Statement

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.

E-Verify Participation

We are an E-Verify participating company.

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 talent@fuzehealth.com.

Security Notice

Individuals are impersonating Fuze Health recruiters and executives. Verify all communications originated from @fuzehealth.com.

Privacy Notice

To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants.

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.

If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent@fuzehealth.com.

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