Senior Software Engineer

Acacia Consulting; New York (NY); On-site; USD 120,000 - 180,000; Full time

Job summary

Acacia Consulting is hiring an early engineering hire to build an AI-native pharmacy services platform. You will work closely with the Head of Engineering to construct the platform from the ground up, learning prescribing workflows, and shaping the technology at the core of the business.

You will contribute production code from day one, define the stack vision with leadership, and drive architecture decisions to enable scalable product development in a fast-paced startup environment.

Qualifications

• Experience in full-stack web development with Python/TypeScript.
• Experience deploying code to AWS and managing cloud resources.
• Experience integrating with third-party APIs; healthcare data like HL7 FHIR is a plus.
• Past experience on an early-stage team (Seed/Series A) is advantageous.
• Ability to work with product and data stakeholders and translate problems into robust solutions.

Responsibilities

• Contribute production code in early days while learning systems and data.
• Define the application stack vision in collaboration with Head of Engineering.
• Build core platform components and automation to enable rapid product development.

Skills

Full-stack development

Python

TypeScript

AWS

API integration

Collaborative

Product mindset

Ambiguity tolerance

Tools

Git

HL7 FHIR

Job description

Every year, millions of patients are hospitalized because of medication problems, and billions of dollars in taxpayer money are wasted on drugs that deliver little therapeutic value. The reason is structural: no single entity in healthcare looks across a patient's entire medication list to make sure they're on the right drug, at the right dose, at the right time, for the right price. That's the gap our client fills. They're building an AI-native pharmacy services platform that traverses the complex maze of clinical, insurance, and financial data behind every prescription, combining it into a comprehensive view of each patient's optimal medication list. From there, their clinical team executes the last mile: coordinating prescribers, pharmacies, and payers to actually move each patient onto the right regimen, with agentic automation doing the heavy lifting.

They're growing fast and built to win:

• An elite team. Experienced second-time founders with a track record of scaling a prior business to hundreds of millions in revenue, backed by leaders with deep experience across top healthtech and health insurance companies.
• Real traction. Not an idea on a slide, but a commercial product in market today, ready to scale.
• A generational opportunity. Medication mismanagement is the single biggest clinical and financial drain on US healthcare — a multibillion-dollar market, and a chance to reshape how patients get the medications they need.

About the Role

As an early engineering hire, you'll work closely with the Head of Engineering to build the platform from the ground up. You'll spend time with the clinical team to learn the ins and outs of prescribing, form relationships with stakeholders to understand and anticipate their needs, and build the technology at the core of the business — including medication optimization data engines, agentic workflow automation tools, and patient- and provider-facing technologies that integrate deeply into prescribers' workflows.

In your first three months, you will:

• Contribute production code in your first days, as you learn the systems and the data that powers the business.
• Develop a deep understanding of the business strategy, and use it to look around corners and advocate for key technical investments at the right time.
• Work at a variety of paces, fielding emerging requests from stakeholders, iterating on features and MVPs, and helping set high-level product strategy.

In your first six months, you will:

• Define the vision for the application stack, making foundational architecture decisions alongside the Head of Engineering.
• Grow strong relationships across the business, and proactively solve problems where you see them.
• Help build the engineering culture, setting the best practices the team will grow around.

We're looking for someone who is:

• A force multiplier. You know how to get more done in less time. You build tooling and abstractions to accelerate development, and you use AI daily to increase your leverage.
• High horsepower. You move quickly, make fast decisions, and set an internal pace that drives the team to win.
• Product-minded. Your first priority is solving the problem, and weighing technical trade-offs is second nature. You translate loosely defined problems into robust solutions, and you know how to choose the best option even when it isn't the most glamorous.
• Opinionated but collaborative. You've seen enough systems to bring a clear point of view to key decisions. You make good calls on your own, and you want to make the biggest ones together.
• Comfortable with ambiguity. You've worked at an early-stage company and know how to operate there. You move fast without losing sight of the larger goal.

We'll be excited if you have:

• Full-stack web development experience in any modern stack (Python, TypeScript, or anything transferable), across at least a few roles.
• An understanding of how the code you write is deployed and run in a cloud environment like AWS.
• Experience integrating with third-party APIs, with a bonus if those systems involved health data like HL7 FHIR.
• Past experience on an early-stage team (Seed or Series A).
• Comfort working directly with stakeholders, including product and data teams.

Our client is an equal opportunity employer, committed to building a company that reflects the diversity of the population they serve, with a hiring process that is fair, inclusive, and free from discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, age, disability, veteran status, or any other characteristic protected by law.