Senior Full-Stack Software Engineer
Alpacahealth · New York City, NY
About this role
📌 **ABOUT ALPACA HEALTH** Alpaca Health enables clinicians to become entrepreneurs, starting in autism care. We help clinicians launch and scale their own clinics by providing **AI-powered software**, **payer contracting**, and **full back-office infrastructure**. We’ve raised **$14M+** from early-stage investors and are building for long-term category leadership—serving **hundreds of patients** while growing **30% MoM**. **Location:** New York City or San Francisco (5 days in-office) --- 🎯 **ROLE: SENIOR FULL-STACK SOFTWARE ENGINEER** You’ll be the person who **owns the platform foundation**—not just reviewing PRs. You’ll design, build, and stand behind core systems such as: - **Data models** - **Money logic** - **State machines** - **API contracts** - **AI infrastructure** You’ll work across high-impact problems—from schema migrations to building LLM pipelines for clinical documentation, to debugging billing edge cases (e.g., payer-specific scenarios). --- 🚧 **WHAT YOU’LL OWN** **1) AI-Native Clinical Workflows** Build products that assist with clinical documentation, treatment planning, reassessments, supervision, and administrative work. **2) Revenue & Payments Infrastructure** Own systems that determine how services are authorized, billed, adjudicated, and paid—ensuring accuracy, timeliness, and trust. **3) Provider Business Operations** Build tools that make credentialing, contracting, compliance, payroll, scheduling, and staffing feel effortless. **4) Patient & Family Experiences** Design experiences across intake/onboarding, scheduling, communication, progress tracking, and payments. **5) Internal Automation Systems** Automate operational work currently handled via spreadsheets/inboxes—across credentialing, billing, authorizations, and care coordination. **6) Platform Foundations** Own the underlying systems: **security, compliance, reliability, AI infrastructure, production systems**, and more. **Expectation:** Own products **end-to-end**—from database schema to user experience. --- 🧠**WHO YOU ARE** - You’ve built in domains where mistakes matter (fintech, healthcare, insurance, logistics, etc.) - You think in **systems**: states, transitions, invariants, and edge cases - You have strong **product instincts** and care about UX - You thrive in **ambiguity** and can drive execution without a fully written PRD - You operate with **high ownership**—making problems disappear, regardless of org boundaries - You’re **AI-native**, using AI daily and experimenting with new leverage - You balance **speed with judgment** and avoid accumulating technical debt - You enjoy learning complex domains (regulations, payer rules, credentialing, exceptions) - You still love writing code and want to build, not manage process --- ✨ **NICE TO HAVE** - Experience building AI-powered products in production - LLM workflows/agents/evals or developer tooling - Modeling complex operational or financial systems - Healthcare/EHR/insurance/revenue cycle experience - Early-stage startup experience owning large parts of the product --- 🚀 **WHY JOIN NOW** The next year’s decisions—domain model structure, enforced state machines, and safe AI workflow design—will shape the system long-term. You’ll join after product-market fit but before the platform fully catches up to the business—building the foundation for a fast-growing system to scale correctly. **Founding engineer autonomy, real ownership, and a company clearly on its way somewhere
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