Principal Software Engineer

Who We Are and Why Join Us 

At OnMed our purpose is simple but powerful...to improve the quality of life and sense of well-being in our communities by bringing access to healthcare to everyone, everywhere. Our path to everywhere has already begun, with our innovative CareStation, a small but mighty, Clinic-in-a-Box, bringing #healthcareaccess anywhere with an outlet to plug it in. Poised to become a key component in America’s public health infrastructure, the OnMed CareStation is the only tech-enabled, AI-powered, human-delivered, hybrid care solution that combines the comprehensive experience, trust, and outcomes of a clinic with the rapid scalability of virtual care.  

At OnMed, every role, every day is directly impacting the communities we serve. You’ll join a high-performing purpose-driven team, innovating to break down the barriers that keep people from the care they need.  

This is not just a job...it's a movement to bring access to healthcare where and when people need it most. It’s healthcare that shows up. 

Who You Are   

You think in systems, not tickets. You have shipped and operated user-facing software end to end — browser to API to database to deployment — and carry the scars, and the judgment, that come with it. You can go deep on interface performance, API and data design, and distributed systems, and just as easily step back to explain a tradeoff to a product or clinical stakeholder. You are as comfortable profiling a slow query or untangling a rendering bottleneck as you are shaping the architecture the next two years of the product will sit on. You have made AI-aided development a real multiplier in your own work as a discipline paired with rigorous design and review. You raise the technical bar for everyone around you, leading by example, and you’re energized by the idea of building software that keeps a healthcare device working when someone needs it most. 

The Role 

OnMed is looking for a Principal Software Engineer to serve as the senior-most individual technical contributor across our software stack — the web and device-facing front ends, the services and APIs behind them, the data stores they depend on, and the cloud infrastructure it all runs on. You’ll own the architecture that lets features move reliably from idea into production across the CareStation fleet — front-end applications, service and API design, data modeling, deployment automation, observability, and the platform patterns other engineers build on. This is a hands-on role: you’ll write code, review designs, and be the person the team turns to on the hardest technical problems, while mentoring engineers and shaping technical direction without formal management responsibility. 

This role reports to the Head of Engineering & AI.

What This Role Solves For: 

• A clear, scalable architecture that carries product features from prototype to reliable production use across the full stack 
• Consistent engineering standards across the full stack as the team and technical surface area grow 
• Technical depth on the hardest engineering problems — latency, reliability, data integrity, security, cost — without waiting on outside consultants 
• AI-aided development practiced with rigor, so the team ships faster without quietly accumulating design, quality, or security debt 

Key Responsibilities 

Technical Leadership & Architecture 

• Serve as the senior-most technical voice on full-stack engineering decisions, partnering closely with the Head of Engineering & AI on strategy and roadmap 
• Set the standard for AI-aided and agentic development — establishing the patterns, guardrails, and review practices that let the team move faster without compromising sound design — and drive effective usage habits across the team 
• Lead design reviews and architectural decisions for cross-team initiatives, balancing speed, maintainability, and long-term scalability 
• Identify technical risk early — in scalability, security, data integrity, or performance — and drive it to resolution    

Full-Stack Architecture & Engineering 

• Design and own the architecture for OnMed’s patient- and clinician-facing applications and the services, APIs, and data models behind them 
• Set the standards for API and service design — clear boundaries, versioning and backward compatibility, contract documentation, and consistent authentication and authorization patterns as the number of consumers grows 
• Drive front-end architecture and performance — component structure, state management, accessibility, and real interaction latency on the hardware patients and clinicians actually use 
• Raise the bar on delivery infrastructure: automated testing strategy, CI/CD, infrastructure-as-code, environment and configuration management, and safe, repeatable deployments 
• Drive observability across the stack — structured logging, metrics, tracing, and alerting — catching latency, error-rate, and data-quality regressions before they reach patients or clinicians 
• Build security and privacy into the design: secure coding practice, secrets and access management, dependency risk, auditability, and protection of PHI in a regulated environment 
• Profile and optimize where it actually matters — query plans, hot paths, payload sizes, chatty interfaces, and cloud spend — and teach the team to measure before rewriting 

AI-Aided Development Practice 

• Model excellent practice with AI coding agents and assistants: decomposing work, supplying the right context, specifying intent precisely, and iterating toward a sound design rather than accepting the first output that runs 
• Hold AI-generated code to the same bar as anything else — architectural fit, test coverage, readability, performance, and security — and make that review standard explicit and teachable 
• Establish and evolve the team’s AI-aided workflow: tooling, repository conventions and context files, specification and prompting patterns, and guardrails for sensitive code and data 
• Show measurable leverage from these practices, and coach engineers on where they help, where they don’t, and how to tell the difference 

Mentorship & Cross-Functional Partnership 

• Mentor engineers across the team, raising the overall technical bar through code review, design feedback, and hands-on pairing 
• Must be comfortable working with global, multicultural teams within a ‘follow the sun’ support and development model 
• Partner with Product, Clinical, and Hardware teams to translate healthcare and operational requirements into robust technical designs 
• Represent engineering in cross-functional planning, giving realistic estimates and surfacing tradeoffs early 
• Perform other related role’s responsibilities as assigned 

Knowledge, Skills and Abilities 

• Strong experience with a full modern tech stack for consumer-facing, microservice-based web applications — modern JavaScript/TypeScript and a component framework (e.g. React), REST API design, object-oriented and functional design, and relational databases 
• Strong software architecture skills, with the ability to design systems that stay reliable and maintainable as scope grows 
• Proficiency in Python and at least one systems-level language (e.g. C#/.NET, Java, etc); strong SQL, including schema design and query optimization 
• Practical experience with cloud infrastructure (Azure preferred), containerization, infrastructure-as-code, and CI/CD 
• Demonstrated effectiveness with AI-aided development tools and agentic workflows, with concrete examples of using them to improve design quality and delivery speed — and the judgment to know when to slow down and keep a human in the loop 
• Depth in performance and reliability work: profiling, load testing, caching, latency budgets, and root-cause analysis on live systems 
• Fluency with automated testing strategy (unit, integration, end-to-end) and the code review, type safety, and static analysis practices that keep a growing codebase safe to change 
• Working knowledge of application security fundamentals — authentication and authorization, OWASP-class vulnerabilities, secrets management, and safe handling of sensitive data
• Ability to communicate complex technical tradeoffs clearly to both engineers and non-technical stakeholders 
• Sound judgment for ambiguous, high-stakes problems, with a bias toward pragmatic, well-reasoned solutions over gold-plating 
• Experience with healthcare, medical device, or other highly regulated data environments is preferred
• Exposure to event-driven architecture, background job processing, or real-time communication (WebSockets/WebRTC) is preferred

Education and Experience 

• Bachelor’s degree in Computer Science, Engineering, or a related field; Master’s degree a plus, or equivalent practical experience 
• 10+ years of professional software engineering experience, including significant hands-on work building and operating production web applications end to end 
• Demonstrated track record of owning complex technical systems end-to-end, from design through production operation 

OnMed provides a competitive salary and benefits package, including unlimited PTO and paid holidays. 

The base salary for this role is up to $200,000 to commensurate with the candidate's experience.

OnMed is a proud equal opportunity employer. All qualified applicants will be considered without regard to race, color, creed, religion, gender, sexual orientation, national origin, genetic information, disability, age, marital status, veteran status, or any other category protected by law.