Senior Software Engineer, Care

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As a Senior Full Stack Engineer on the Care Team, you will join a team that is working to improve patients’ lives through a better pharmacy experience. The Care Team owns the services that manage all of prescription processing from intake up to the moment we send an order to our pharmacies for fulfillment. The key focus areas for the Care Team include preparing prescriptions for fulfillment and delivery as quickly and accurately as possible through a combination of automation and efficient manual task coordination when third‑party input is required to advance a fill;

enabling the growth of the business by enabling partners like drug manufacturers, insurers, and individual providers to easily configure billing, benefits, and clinical workflows tailored to their use cases.

• Increase Alto’s intake automation rate by leveraging LLMs to parse unstructured data from prescriptions
• Accelerate pharmacist workflows by integrating controlled substance dispensing history and risk scores into our pre‑dispense clinical safety and review step
• Optimize the selection of which drug to dispense to find patients the best price

• Excited about balancing low inventory on hand with high availability
• Establish the foundations for an extensible inventory management platform to fuel business growth
• Mentor other engineers, encouraging best practices in software development and design
• Solve complex technical problems at the intersection of healthcare and e‑commerce
• Thought leader on how to build world class predictive systems

• Bachelor's degree in Engineering or equivalent experience
• 10+ years of progressive software engineering experience in a high volume, high throughput production environment
• Background in Backend or Full Stack technologies
• Expertise in architecting complex systems for long‑term maintainability, performance, and scalability
• Strong engineering fundamentals and experience building high volume, high throughput, resilient systems.
• Proven track record of technical best practices, including code style, documentation, code review, bug fixing, and production issue mitigation.
• Relentless in pursuing impact through their work.

• Solid experience with supply chain optimization systems.
• Proficiency in Alto's tech stack:
  Rails, Python, and Postgre
  
  SQL.
• Experience building and integrating predictive ML models.
• Demonstrated ability to thrive in a dynamic entrepreneurial environment and maintain a growth mindset.
• A pragmatic approach to problem solving that’s biased towards impact.
• A strong sense of ownership over your work and a desire to uplevel your peers.
• Passion for Alto’s mission and our company values.
• Experience designing and implementing service oriented architectures.

Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, periodically move away from the computer terminal for in‑person meetings, 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 objects up to 50 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.

Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Alto’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.

Salary Range: $172,000 - $215,000

Commission Eligible:
No

Travel:
Yes - Required up to 15% of the time for engineering onsite or off‑sites.

Location Requirement:
Employment at Alto is limited to individuals residing in the following states:
California, Connecticut, Colorado, Florida, Nevada, Illinois, New York, Kansas, Texas, Maryland, Washington…