Software Engineer .Net/AI Developer

Optivate; Town of Florida (NY); On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Collaborative team environment

Ownership of initiatives

Opportunity to work on healthcare challenges

Job summary

Optivate in New York, United States is looking for a full-stack .NET engineer who is AI-native, focusing on building production software for healthcare. The role involves designing and shipping AI-powered features across their ophthalmology platform using .NET/C# and HTML/CSS.

The ideal candidate should have 3–7 years of experience in software development, strong proficiency in .NET/C#, and familiarity with AI-assisted tooling. A collaborative spirit and comfort in agile environments are essential.

Qualifications

• 3-7 years of professional software development experience with strong full-stack delivery.
• Strong experience with .NET/C# (.NET Core and/or .NET 10).
• Proficiency in building responsive UIs with HTML/CSS.

Responsibilities

• Design and ship AI-driven features across the ophthalmology platform.
• Build full-stack features utilizing .NET/C# and responsive HTML/CSS.
• Work within an agile framework and contribute to team processes.

Skills

Full-stack development

.NET/C#

AI-assisted development tooling

HTML/CSS

Collaboration

Tools

Cursor

Claude Code

Copilot

AWS

Azure

Job description

Optivate is a leading provider of healthcare technology software solutions purpose-built for ophthalmologists and eye care specialists. The company's solutions, which include EMR, practice management, patient engagement, image management, and RCM and billing services are designed to streamline clinical documentation workflows and improve daily practice efficiencies for eye care professionals.

Applicants must be local OR be willing to relocate to the Bonita Springs area within a reasonable time frame following their start date.

Position Summary

We're hiring a full-stack .NET engineer who is AI-native — someone who builds production software end to end and who works fluently with modern AI development tooling and agentic workflows.

"AI-native" here means two things, and we care about both:

• You build with AI. You use AI-assisted and agentic development tooling (e.g., Cursor, Claude Code, Copilot) as a core part of how you work — including multi-agent workflows where separate agents handle decomposition, architecture, development, QA, and code review. You know how to drive these tools to ship faster without sacrificing quality.
• You build AI into products. You're comfortable integrating LLMs and ML capabilities into real applications, and you understand the production and safety constraints that come with doing that in healthcare.

The bulk of this role is full-stack .NET product engineering. A meaningful and growing portion involves designing and shipping AI-powered features across our platform. This is hands‑on building role, not a research role — we’re looking for someone who has built, integrated, and shipped software that users depend on, and who reaches for AI tooling instinctively to do it well.

You Will

• Design and ship AI‑driven features across our ophthalmology platform.
• Work with third‑party LLM integrations.
• Build domain‑specific enhancements using clinical data.

This is not a research role. We are looking for someone who has built, integrated, evaluated, and deployed AI systems in production environments.

What You’ll Do:

• Design, build, and maintain full‑stack features across our ophthalmology platform — backend services and APIs in .NET/C# (.NET Core, .NET 10) and responsive frontend interfaces in HTML/CSS.
• Use AI‑native and agentic development workflows (e.g., Cursor multi‑agent pipelines for decomposition, architecture, implementation, QA, and review) to move quickly while keeping code clean and reliable.
• Design and integrate AI‑powered features — including third‑party LLM integrations — that fit safely into clinical software.
• Troubleshoot and improve distributed systems.
• Establish and participate in code review processes.
• Work within an agile framework, contributing to sprint planning, daily standups, and retrospectives.
• Write clean, maintainable, testable code, and participate in code review.
• Collaborate across product, clinical, and engineering teams.
• Contribute to architectural decisions, including where and how AI fits into our systems.

Depending on the work in front of us, you may:

• Integrate third‑party LLMs (OpenAI, Anthropic, Azure OpenAI, Hugging Face) into production features.
• Build retrieval pipelines using embeddings and vector databases (Pinecone, FAISS, Weaviate) and implement semantic search.
• Develop prompt engineering strategies with testing and versioning.
• Design evaluation approaches that measure accuracy, reliability, hallucination rates, and clinical relevance.
• Collaborate on deploying, monitoring, and maintaining AI services in production.
• Optimize AI feature performance, latency, and cost.

Required Qualifications

• 3–7 years of professional software development experience with strong full‑stack delivery.
• Strong, current experience with .NET/C# (.NET Core and/or .NET 10).
• Proficiency building responsive UIs with HTML/CSS.
• Demonstrated fluency with AI‑assisted and agentic development tooling (e.g., Cursor, Claude Code, Copilot), ideally including multi‑agent development workflows.
• Experience integrating LLM APIs into real, shipped systems.
• Solid foundation in data structures, algorithms, API design, and distributed system design.
• Experience with at least one major cloud platform (AWS, Azure, or GCP).
• Familiarity with model limitations, evaluation tradeoffs, and the realities of running AI in production.

Team & Process Experience

• Experience working in collaborative environments with exposure to Git version control and branching strategies.
• Agile methodologies (Scrum/Kanban).
• Task/story management tools.
• Code reviews.
• Cross‑functional collaboration.
• Pragmatic builder who understands production constraints.
• Comfortable with ambiguity in emerging AI spaces.
• Strong communicator, especially explaining AI tradeoffs.
• Motivated to apply AI in healthcare where safety and reliability matter.

Nice to Have

• Experience with Blazor, particularly Blazor Hybrid and .NET MAUI for building cross‑platform applications on a shared .NET codebase.
• Experience building or fine‑tuning ML models (NLP, structured data, computer vision).
• Enhancing foundation models with RAG, fine‑tuning, embeddings, or adapters.
• Computer vision experience, especially medical imaging.
• Experience with clinical or regulated datasets; HIPAA familiarity.
• Reinforcement learning or simulation experimentation (Gymnasium a plus).
• OAuth and systems integration patterns; RESTful API design.
• Git branching strategies and experience in Scrum/Kanban environments.

What We Offer

• A core role building real software that eye care practices depend on every day.
• The chance to work AI‑native — both shipping AI‑powered features and using cutting‑edge agentic development tooling as part of how we build.
• Ownership over meaningful initiatives and a voice in architectural decisions.
• A collaborative team at an exciting inflection point.
• Challenging, mission‑driven problems in healthcare.