Principal Full Stack Software Engineer – Ruby on Rails

Responsibilities

• Drive collaboration on technical direction for complex, cross-cutting systems — data modeling, API design, clinical workflow architecture, and integration patterns
• Scope and shape work end-to-end: from identifying the right problem to solving it, collaborating closely with product and design to define what “done” looks like
• Write code across the entire stack (currently Ruby + Rails on the backend and Turbo/Tailwind on the frontend) with a focus on the systems and abstractions that other engineers build on
• Evaluate technical risk and tradeoffs clearly — know when to invest in architecture and when to ship the simplest thing that works
• Mentor and elevate the team through architecture discussions, pairing, code review, and setting high standards without gatekeeping
• Build deep domain expertise in our problem space and use it to challenge product assumptions, surface risks early, and advocate for provider and member experience
• Collaborate across engineering, product, design, and clinical/operations teams to ensure technical decisions serve business and clinical goals

• You're excited about improving behavioral health for children, teens, and their families
• You have significant experience developing software professionally, primarily Ruby + Rails, with a track record of influencing technical direction beyond your own code
• You shape how the team thinks about systems — you see how individual features connect to the broader architecture and can articulate tradeoffs to technical and non-technical stakeholders
• You own problems, not just tickets — you dig into the domain, question assumptions, and find the right solution even when it's not the obvious one
• You are thoughtful and empathetic in how you carry yourself, from decision making and execution, to communication and collaboration
• You raise the bar for the team through your work, your feedback, and your willingness to make things better without being asked
• You thrive in a flat, self-managing team where influence comes from clarity and trust, not authority
• You have developed your own workflow for building software with AI coding tools — you have opinions about when agents help, when they hurt, and how to get the best out of them
• You care about solving problems and aren't tied to particular solutions or technologies
• Bonus Points:
  • Healthcare — especially clinical workflows, scheduling systems, EHR integrations, insurance billing, or multi-clinic operations
  • Complex data modeling and migration challenges (unifying systems, managing domain complexity)
  • API development and integrating with third-party systems
  • Working in Shape Up or similar appetite-based development methodologies