About You, the RoleWe're looking for a
Senior Software Engineer to join our Healthcare Interoperability team; the group responsible for connecting Axle Health's scheduling and workforce management platform directly into the daily workflows of home healthcare providers. This is a high-leverage, high-ownership role: you'll design and build the integrations that make Axle Health indispensable to our customers, and you'll help shape how our team works as we scale.
Our ideal candidate brings deep backend expertise, strong architectural instincts, and a genuine passion for solving complex problems in systems that matter. You've built reliable, high-volume systems before, whether at scale at a growth stage company or from the ground up at a startup, and you know how to lead technical work across a team without losing your connection to the code. If you're energized by meaningful technical challenges and want your work to directly improve care delivery for patients, we want to hear from you.
What you'll do:- Design and implement Electronic Health Record (EHR) or Electronic Medical Record (EMR) integrations that connect Axle Health's platform into providers' existing tech stacks
- Architect high-volume backend systems built to support hundreds of thousands of patients reliably and at scale
- Develop and evolve API integrations across the Axle Health ecosystem, with a focus on performance, security, and maintainability
- Lead technical design discussions and drive engineering decisions from initial scoping through delivery
- Collaborate with and provide technical leadership to other engineers, setting a high bar for code quality through thorough and constructive code reviews
- Mentor junior and mid-level engineers, investing in their growth and helping them develop strong engineering fundamentals
- Write clear, thorough documentation to scale team knowledge within the Interoperability team and across engineering
Required skills and experience:- Bachelor's degree
- 7+ years of professional software engineering experience
- Expertise building backend systems in Node.js + TypeScript (1-2+ years)
- Hands-on experience designing and working with SQL databases (PostgreSQL preferred)
- Demonstrated ability to architect scalable, performant, and secure systems - not just implement within them
- Strong technical communication skills (able to explain complex decisions clearly to both technical and non-technical stakeholders)
- Proven ability to conduct rigorous, constructive code reviews that improve both code quality and team capability
- Experience working in fast paced, high-growth startup environments with a desire to build and a track record of operating with significant autonomy
- Demonstrated ability to self-learn and quickly adapt to new technologies
Nice to have:- Experience working with Electronic Health Records (EHRs) and/or healthcare interoperability standards (FHIR, HL7)
- Background in a domain where data integrity and security are non-negotiable (healthcare, fintech, etc.)
- Experience working on systems with significant data volume or uptime requirements
- Working knowledge of CI/CD, DevOps practices, and build systems
- Familiarity with the Axle Health tech stack: ExpressJS, GraphQL, React, React Native, PostgreSQL, AWS, Datadog
Tools You May Use- ExpressJS + TypeScript
- GraphQL + React + React Native
- PostgresSQL
- AWS
- Datadog
- Git / Github / Graphite
- Django + Python3
- Claude Code and Cursor
