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 with **AI-powered software**, **payer contracting**, and **full back-office infrastructure**—so providers can focus on patient care while ownership becomes possible. We’ve raised **$14M+** from early-stage investors and are serving **hundreds of patients**, growing **30% MoM**. This is a **full-time** role for candidates based in **New York City or San Francisco**, with a **5 days in-office** culture. --- 🎯 **Role: Senior Software Engineer** You’ll be the person who **owns the platform foundation**—including **data models, money logic, state machines, API contracts, and AI infrastructure**. This is not “owning” in the sense of reviewing PRs. You’ll **design it, build it, and stand behind it**. You’ll work across high-impact problems, from **schema migration strategies** to building **LLM pipelines for clinical documentation**, to debugging **billing edge cases** (e.g., payer sequencing scenarios). --- 🚧 **What You’ll Own** - **AI-Native Clinical Workflows**: clinical documentation, treatment planning, reassessments, supervision, and administrative workflows. - **Revenue & Payments Infrastructure**: authorization, billing, adjudication, and payment systems—ensuring accuracy and trust. - **Provider Business Operations**: credentialing, contracting, compliance, payroll, scheduling, and staffing—making practice operations feel effortless. - **Patient & Family Experiences**: intake/onboarding, scheduling, communication, progress tracking, and payments. - **Internal Automation Systems**: automate operational work currently handled via spreadsheets/inboxes across credentialing, billing, authorizations, and care coordination. - **Platform Foundations**: data models, APIs, security, compliance, reliability, AI infrastructure, and production systems. **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, or similar). - You think in **systems**: modeling states, transitions, invariants, and edge cases. - You have **strong product instincts**: translate real provider pain into simple UX backed by correct logic. - You thrive in **ambiguity**: identify key questions, propose solutions, and drive execution without a fully written PRD. - You operate with **high ownership**: solve blockers regardless of org chart. - You’re **AI-native**: use AI daily and experiment with new ways to increase leverage. - You balance **speed with judgment**: move fast without leaving unmanageable technical debt. - You enjoy learning complex domains (exceptions, regulations, payer rules, credentialing, operational edge cases). - You still love writing code: lead major technical decisions while building. --- ✨ **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—how the domain model is structured, how state machines are enforced, and how AI workflows are built safely—will shape the system long-term. You’ll join **after product-market fit**, but before the pl
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