Principal Engineer

Fuze Health

$209K — $262K *
US-AnywhereRemote in United States
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Computer Science, Software Engineering, or a related technical discipline.
  • 10+ years of software engineering and systems design experience; 3+ years at a senior architectural level.
  • Extensive background in B2B SaaS or transactional systems.
  • Mastery of AWS, PostgreSQL, Ruby on Rails, Python, TypeScript, and JavaScript.
  • Exceptional communication skills for engaging non-technical stakeholders.
  • Proven ability to design complex distributed systems and optimize relational database queries.

Responsibilities

  • Define and evolve architecture for FuzeRx's B2B and consumer platforms.
  • Lead design and implementation of high-volume API integrations and complex fulfillment logistics.
  • Mentor engineers and elevate the engineering culture through design reviews and technical sessions.
  • Establish and enforce engineering standards, including coding guidelines and security principles.
  • Collaborate with Product Management and Pharmacy Operations to align technical architecture with business goals.
  • Architect systems to support compliance with healthcare regulations like HIPAA and SOC2.
  • Drive initiatives to optimize performance and database efficiency in AWS infrastructure.

Benefits

  • Dental, vision, and multiple group medical plans to choose from.
  • 401(k) retirement savings plan.
  • Flexible spending account (FSA) and health savings account (HSA).
  • Employer-paid short-term and long-term disability insurance.
  • Flexible vacation time and paid sick time.
  • Eight weeks of paid parental leave and additional paid leave for birthing parents.
  • A Lifestyle Spending Account allowance each month.
Full Job Description
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 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.

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.

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.

More Benefits Information Here: Fuze Health Benefits Site

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