Senior Software Engineer, Applied AI

VIVIO Health

$165K — $205K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 7+ years of experience in building production software with ownership of critical systems.
  • Strong proficiency in Python and experience with FastAPI or a similar asynchronous framework.
  • Solid SQL knowledge on MySQL or Postgres, with familiarity in AWS.
  • Comfortable in using server-rendered front end technologies (Jinja2, Tailwind, Alpine.js).
  • Proficient in Linux for development and able to access a remote desktop from a Windows workstation.
  • Experienced in daily use of AI coding tools with a practical viewpoint on their effectiveness and limitations.
  • Shipped at least one LLM-powered feature to real users, along with evaluation experience.

Responsibilities

  • Build and enhance AI capabilities using AWS Bedrock, focusing on document processing and decision support.
  • Establish and maintain evaluations for AI features to monitor quality over time.
  • Manage practical challenges in production AI, including cost and latency considerations.
  • Utilize AI coding tools as part of your workflow and ensure their output is verified.
  • Design and develop backend features in Python and FastAPI, and maintain a focus on fixing existing issues.
  • Oversee integrations for data exchange with carriers and pharmacies, ensuring compliance with standards.
  • Implement testing and lint gates to ensure quality in continuous integration processes.

Benefits

  • Comprehensive medical, pharmacy, dental, and vision coverage.
  • Life insurance provided for employees.
  • Eligibility for stock options as part of the benefits package.
  • 401(k) plan with a company match to support retirement savings.
  • Paid time off (PTO) for work-life balance.
  • Dynamic and collaborative work environment fostering team engagement.
  • Opportunity to contribute to meaningful projects in a growing Public Benefit Corporation.
Full Job Description
Job Description

About the role

VIVIO Health is transforming how it operates with AI, and we are hiring a senior engineer to build the features that make that real: language-model capabilities for our clinical, client success, and member experience teams, built on AWS Bedrock and related models and shipped to real users. Your job is to take a business problem from one of those teams, work out where a model helps and where it does not, and deliver something the team uses every day. This is not a research role. The AI work lives inside our production platform, so you will also ship application features, work with the integrations that exchange data with our partners and build the test and quality practices that keep all of it reliable.

Our clinical programs are the first area we are transforming with AI, so your early work will be with the clinical team and the documents, reviews, and decisions that run through it. Other business areas follow as the platform stabilizes.

The role is remote, with structured written communication as the default working mode. You report to the Head of Engineering and work directly with the business owners of the problems you solve.

What you will do
  • Build and extend LLM-backed capabilities on AWS Bedrock and related models: document OCR and extraction on clinical and claims paperwork, summarization and decision support for clinical review, Knowledge Bases for retrieval over plan and policy documents, and workflow automation for internal teams
  • Establish and maintain evals for the AI features you ship, so we know when quality drifts
  • Handle the practical side of production AI: structured output, failure modes, cost, latency, and knowing when a deterministic approach beats a model
  • Use agentic coding tools (Claude Code and Kiro) as a core part of your workflow, and own the verification of what they produce
  • Design, build, test, and ship features in our Python and FastAPI back end on MySQL and AWS, and our Jinja2, Tailwind, and Alpine.js front end, with a bias toward fixing what is broken before adding what is new
  • Work with the integrations that exchange eligibility, accumulator, and claim data with carriers and pharmacies, including NCPDP D.0 and X12 270/271 transactions and the file formats behind them
  • Put test and lint gates in place where they are missing, and treat CI as part of the definition of done
  • Treat PHI handling as a first-class design constraint in everything you build
  • Write clear specs, prompts, and design notes; at this level, written communication is an engineering skill

How we work

Development happens in a managed Linux environment that you reach by remote desktop from a Windows endpoint; PHI never lands on a laptop. You need to be fluent in both: Linux for the actual engineering, Windows as the workstation you get there from.

Qualifications

What we need
  • 7+ years building production software, with real ownership of systems that other people depend on
  • Strong Python with production FastAPI (or a comparable async framework) experience, solid SQL on MySQL or Postgres, and working knowledge of AWS
  • Comfortable in a server-rendered front end (Jinja2, Tailwind, Alpine.js or htmx); we are not looking for a React specialist
  • Fluent in Linux for development and comfortable working from a Windows workstation over remote desktop into a secure environment
  • Daily use of AI coding tools on real work, and a clear point of view on where they help and where they fail
  • At least one LLM-powered feature shipped to real users, including how you evaluated it and what went wrong
  • Practical knowledge of prompt and context engineering, retrieval, embeddings, and structured output
  • Working knowledge of healthcare data exchange standards and file-based integrations: NCPDP D.0, X12 270/271, SFTP, fixed-width and delimited formats, and reconciliation
  • Direct communicator who names tradeoffs plainly and asks when something is unclear

Nice to have
  • Healthcare or other regulated-data experience (HIPAA, PHI, SOC 2)
  • Pharmacy benefits, claims, or clinical program experience
  • Self-hosting open-source models (Llama, Qwen, Mistral, or similar) with vLLM, Ollama, or TGI, including GPU sizing, quantization, and serving inside a private network
  • Fine-tuning or adapter training on domain data
  • Classical ML for prediction or scoring (scikit-learn, XGBoost), with model monitoring in production
  • Master's degree in computer science or a related field

How we hire

An HR phone screen, a technical interview that includes a short practical exercise (extract structured data from messy documents and show us your evals), a conversation with the Head of Engineering, and a final conversation with one or more of the business leaders you would support. Our interviews are a mix of phone calls, Video interviews and an on-site visit to our corporate office.

Additional Information

Compensation and Benefits:
  • The anticipated salary range for this position is $165K-$205K base. The actual salary offered will be determined by a variety of factors, including the candidate's qualifications, experience, and the position's geographic location.
  • Bonus Eligible
  • Comprehensive Benefits Package:
  • Medical, Pharmacy, Dental, Vision
  • Life Insurance
  • Stock Options
  • 401(k) with Company Match
  • PTO
  • Full-time position
  • Dynamic, collaborative work environment
  • Opportunity to make a real impact at a growing Public Benefit Corporation

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