Principal Software Engineer

Prescryptive Health, Inc.; United States; On-site; USD 185,000 - 255,000; Full time

Benefits offered by this job

Flexible paid time off (including 12)

401(k) with company match

100% employer‑paid medical, dental, &

Health Savings Account contributions

Stock options

Job summary

Prescryptive Health, Inc. is seeking a Principal Software Engineer to shape technical direction across teams and drive architectural bets with lasting impact.

You will work with engineering leadership, domain leads, and product managers to connect strategy to business outcomes and solve the hardest, most ambiguous problems. You will elevate technical judgment through reviews, mentor staff, own cross-cutting concerns, and own system architectures for our B2B portals, internal platforms, and

Qualifications

• 10+ years of software development experience.
• Strong architectural experience designing systems that span multiple services, teams, or domains.
• Hands-on engineering across the full stack using Go, TS, C#, and React.
• Authorization to work permanently in the United States.

Responsibilities

• Elevate the technical judgment of engineers through design reviews, architectural guidance, and mentorship.
• Troubleshoot and drive resolution of the hardest cross-system issues in our stack.
• Participate in on-call rotation to ensure system reliability and rapid issue resolution.
• Engage directly with product and executive stakeholders to assess feasibility, cost, and risk of strategic initiatives.
• Drive architectural decisions and technical direction across multiple teams and systems.
• Directly build and ship software that tackles the hardest, most ambiguous technical problems in our stack.
• Set the engineering standard through your own code, design patterns, and technical approach.
• Own cross-cutting concerns including scalability, reliability, security posture, and cloud cost efficiency.
• Identify converging efforts across teams and consolidate them before they become compounding technical debt.
• Design and evolve system architectures for our B2B portals, collaboration tools, internal platforms, and customer-facing APIs.
• Evaluate build-versus-buy decisions, technology bets, and system design tradeoffs with direct business impact.

Skills

Full stack engineering

Go

TypeScript

C#

React

Architectural design

Cloud architecture

Cross-team leadership

SQL databases

Event-driven architectures

AI-assisted development

Tools

GraphQL

Kubernetes

Terraform

CI/CD

Job description

Prescryptive is the healthcare technology company enabling the direct-access marketplace for prescription drugs. Our platform aligns incentives so affordability, choice, and patient access become the natural outcome of a functioning system.

Learn more about us by following us on LinkedIn or visiting Prescryptive.com.

About This Role

As a Principal Software Engineer, you'll shape how the organization builds software. That means setting technical direction across teams, making architectural bets with lasting impact, and ensuring the organization focuses its energy on the problems that matter most.

Your impact will show up in the systems you build, the quality of technical decisions across the organization, the alignment you create between teams, and the clarity you bring to complex problems.

You'll work directly with engineering leadership, domain leads, and technical product managers to connect technical strategy to business outcomes. This is one of a small number of roles shaping the company's technical future, and it requires someone who can walk into an unclear situation and leave it with a clear technical path forward.

What You Will Do

• Elevate the technical judgment of engineers around you through design reviews, architectural guidance, and mentorship.
• Troubleshoot and drive resolution of the hardest cross-system issues in our stack.
• Participate in on-call rotation to ensure system reliability and rapid issue resolution.
• Engage directly with product and executive stakeholders to assess feasibility, cost, and risk of strategic initiatives.
• Drive architectural decisions and technical direction across multiple teams and systems.
• Directly build and ship software that tackles the hardest, most ambiguous technical problems in our stack.
• Set the engineering standard through your own code, design patterns, and technical approach.
• Own cross-cutting concerns including scalability, reliability, security posture, and cloud cost efficiency.
• Identify converging efforts across teams and consolidate them before they become compounding technical debt.
• Design and evolve system architectures for our B2B portals, collaboration tools, internal platforms, and customer-facing APIs.
• Evaluate build-versus-buy decisions, technology bets, and system design tradeoffs with direct business impact.

What You Will Bring

• 10+ years of software development experience, having progressed from shipping great software to shaping how organizations approach building it.
• Deep architectural experience designing systems that span multiple services, teams, or domains.
• Exceptional hands‑on engineering skills across the full stack, with the ability to go deep on the hardest problems in any part of the system.
• Strong proficiency across multiple programming languages and the ability to ramp up quickly on new ones. Our stack includes Go, TypeScript, C#, and React.
• Proven ability to own the full software development lifecycle, from requirements and design through construction, testing, deployment, and production operations.
• Experience with cloud architecture and resource‑efficient infrastructure design at scale.
• A full ownership mentality that extends beyond your own code to the health of systems, culture, and teams around you.
• Strong understanding of SQL databases, caching layers, event‑driven architectures, and data pipeline design.
• Pragmatic technical judgment that optimizes for the right solution given real‑world constraints rather than the theoretically perfect one.
• Track record of driving technical alignment across teams with competing priorities.
• Enthusiasm for leveraging AI‑assisted development tools and emerging technologies.
• Ability to translate fluently between business and technical language.
• Authorization to work permanently in the United States.

Ideally You'll Also Have

• Experience with healthcare data standards (HL7, FHIR) or other regulated industry environments.
• Experience with GraphQL, event‑driven data pipelines, or healthcare integration patterns (EHR, PMS, PBM).
• Advanced DevOps and platform engineering experience, including Infrastructure as Code, containerization, and observability at scale.

What We Have to Offer

• The opportunity to grow alongside an early‑stage company transforming a large, established industry.
• Flexible paid time off, including 12 paid holidays.
• 401(k) with company match.
• 100% employer‑paid medical, dental, and vision premiums.
• Company contributions to a Health Savings Account (HSA).
• Stock options.

Compensation

Prescryptive is committed to fair pay practices. The projected annual salary range for this position is $185,000–$255,000.

When preparing an offer, we consider each candidate's experience, qualifications, interview feedback, internal equity, and geographic location.

Equal Opportunity Employer

Prescryptive is an Equal Opportunity Employer. We do not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non‑disqualifying physical or mental disability, national origin, veteran