Principal Software Engineer

Essen Medical Associates

$135K — $160K *
US-AnywhereRemote in Bronx, NY
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 7+ years of professional software engineering experience with principal-level impact
  • Experience with large-scale distributed systems in production
  • Strong backend engineering skills and full-stack comfort
  • Excellent architectural judgment for complex technical designs
  • Experience in healthcare or compliance-heavy environments preferred
  • Comfortable managing systems from design to production operations
  • Familiarity with the tech stack: Python (FastAPI), React/TypeScript, MSSQL, Redis, Azure, Terraform.

Responsibilities

  • Define platform-wide architecture for backend services and infrastructure
  • Lead technical scoping and design for major initiatives
  • Ensure reliability, scalability, and operational excellence
  • Enhance developer experience and tooling
  • Establish and refine engineering standards and best practices
  • Implement significant redesigns and architectural improvements
  • Mentor engineers to improve code quality and collaboration

Benefits

  • Hybrid work model with 3 days on-site and 2 days remote
  • Opportunities for direct interaction with users in a community setting
  • Contribution to a platform that improves healthcare for underserved populations
  • Mentorship and growth opportunities within a senior leadership role
Full Job Description
Job Summary

Position title: Principal Software Engineer

Job Summary:We're hiring a Principal Software Engineer to set the technical direction and own the architecture of our core systems. This is a hands-on senior leadership role. You'll design and evolve foundational systems (APIs, data flows, infrastructure patterns, reliability standards) while acting as a force multiplier for the engineering team.

Responsibilities

What youll own

Platform-wide architecture across backend services and infrastructure

Technical scoping and design for cross-cutting initiatives (EHR integrations, multi-tenancy, scaling)

Reliability, scalability, and operational excellence

Developer experience and internal tooling

Engineering standards and best practices

High-impact system redesigns and architectural improvements

Engineering leverage through mentorship and code review

30/60/90-day plan

Days 0 to 30

Deep dive into platform architecture, codebase, and infrastructure

Audit scaling bottlenecks and reliability risks

Build strong working relationships with the engineering team and clinical stakeholders

Identify 2-3 high-leverage platform improvements

Ship at least one meaningful architectural fix

Days 31-60

Own the technical design for a major architectural initiative

Refine or establish platform-wide engineering standards

Improve observability and reliability patterns across services

Begin scoping and architecting work for other engineers to execute

Days 61-90

Recognized as the technical authority for your domain

Delivering on your first major initiative

Actively shaping the technical roadmap alongside product and leadership

Mentoring engineers and raising the bar on code quality and design rigor

Qualifications

What were looking for

7+ years of professional software engineering experience, with principal-level impact in at least one prior role

Designed and operated large-scale distributed systems in production

Strong backend engineering background; comfortable working across the full stack

Excellent architectural judgment and ability to translate messy, real-world problems into clean technical designs

Experience working in healthcare, EHR integrations, or compliance-heavy environments is a significant plus

Comfortable owning systems end-to-end, from design through production operations

Our stack: Python (FastAPI), React/TypeScript, MSSQL, Redis, Azure (Container Apps, Static Web Apps, DevOps Pipelines), Terraform.

Nice to have

Health tech experience or familiarity with EHR systems (eClinicalWorks, Ellkay, Redox, FHIR)

Experience with HIPAA-compliant systems and healthcare data

Experience scaling a multi-tenant SaaS platform

Experience building clinical rules engines or decision support systems

Public speaking or writing on technical topics

Location

Based in the Bronx, co-located with Essen Health Care. We sit next to the care coordinators, clinicians, and operators who use the platform every day and work in a community that we serve. Instead of scheduling a user research session, you can walk down the block and see someone using what you built.

Hybrid: 3 days on-site, 2 days remote.

Why this role

Youll shape the technical foundation of a platform thats live, growing, and directly improving healthcare for underserved communities.

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