Principal Software Engineer

At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare.

As a Principal Engineer at Fuze Health 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.

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.

About Alto Pharmacy (Fuzehealthcareersite)

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.

Responsibilities

• 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.
• 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.
• 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.
• Establish and enforce engineering standards across the organization, including coding guidelines, testing frameworks, CI/CD pipeline strategies, and security-by-design principles.
• Collaborate deeply with Product Management, Engineering Managers, and Pharmacy Operations to ensure technical architectures align with long-term business goals and clinical requirements.
• Partner with the InfoSec team to architect systems that natively support strict healthcare compliance standards (HIPAA, SOC2), ensuring patient data privacy and secure messaging.
• Spearhead initiatives to optimize system performance, reduce latency, and improve database efficiency within our PostgreSQL and AWS infrastructure.
• Continuously evaluate new tools, frameworks, and AWS services, running proof-of-concepts (POCs) to determine their viability for improving the FuzeRx ecosystem.

Requirements

• 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.
• Education: Bachelor’s degree in Computer Science, Software Engineering, or a related technical discipline.
• 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.
• Extensive background in building and scaling distributed, high-throughput, and highly available B2B SaaS or transactional systems.
• Standard business hours; expected to serve as a Tier 1 technical escalation point for critical architectural outages. [Insert Remote/Hybrid/On-site details].
• 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).
• 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.
• Proven ability to design and implement complex distributed systems, optimize complex relational database queries, and establish automated deployment pipelines.
• 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.
• Applicants must be authorized to work for any employer in the U.S. At this time, Fuze Health is unable to sponsor or take over sponsorship of an employment Visa.

Preferred

• Education: Master’s degree in Computer Science, System Engineering, or related field.
• Active contributions to the open-source community or experience speaking at technology conferences.

Pay

The compensation range provided reflects the applicable national market range for this role and may vary based on the candidate’s geographic location, experience, and qualifications.

Benefits

• $215,840 to $269,800 Commission Eligible: No Incentive/Bonus Eligible: Yes Equity Eligible: Yes Travel: No Benefits: Full-time employee benefits include: dental, vision, and 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, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program).
• Employees are also provided flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non-exempt employees) , and eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month.

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.

More Benefits Information Here

Fuze Health Benefits Site Equal Opportunity Employer Fuze Health is an Equal Opportunity Employer. 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. 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 . 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. We are an E-Verify participating company. Use of 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 .

Privacy Notice

To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants. #LI-Remote Equal Opportunity Employer Fuze Health is an Equal Opportunity Employer. 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. 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 . 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. We are an E-Verify participating company. Use of 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 a t talent@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 .