Staff Software Engineer

The Opportunity

As a Staff Engineer at Pearl Health, you will serve as a technical architect and strategic partner for both your team and our entire system. You will directly influence organizational direction by driving the design and execution of large-scale, cross-functional initiatives that enable Pearl Health to deliver quality healthcare technology at scale. Your expertise will ensure our systems are scalable, reliable, and directly support our mission of transforming primary care delivery for patients who need it most. This is your chance to model engineering excellence, set the technical bar high, and make a visible, long-term impact on the future of healthcare.

Who We Are

Pearl Health is dedicated to empowering primary care providers, health systems, and physician-led networks to succeed in the shift to value-based care. Our platform delivers the technology, financial tools, and expert services that enable practices to provide more proactive, effective care to their Medicare patients, ultimately lowering costs and improving health outcomes.

Founded in 2020, we are a team of healthcare and technology innovators backed by premier investors like Andreessen Horowitz, Viking Global Investors, and AlleyCorp. We partner with thousands of providers across 44 states to build a more sustainable future for American healthcare.

What You'll Do

Technical Leadership & Architecture

• Drive system design and technical planning for projects, including large, complex, cross-functional initiatives

• Partner on architectural decisions for critical systems, ensuring solutions are scalable, maintainable, and aligned with Pearl's long-term technical vision

• Define and implement engineering standards, patterns, and best practices that improve scalability, reliability, and developer productivity across the organization

• Partner to make strategic trade-offs between technical debt, feature delivery, and system reliability, clearly communicating the rationale and impact of these decisions

Full-Stack Excellence

• Design and build high-performance, distributed systems including data pipelines, APIs, and microservices that process healthcare data at scale

• Architect intuitive, responsive web applications and internal tools that enable clinical and operations teams to deliver exceptional patient care.

• Ensure observability, monitoring, and operational excellence across distributed services, cloud infrastructure, and frontend applications

• Apply deep expertise in both backend service design (RESTful and event-driven architectures) and modern frontend frameworks where needed to deliver complete, production-ready solutions

• Champion security best practices, data consistency patterns, and regulatory compliance (HIPAA, SOC2) across the entire application stack

Strategic Collaboration & Influence

• Partner with product, operations, and design leadership to align engineering decisions with company priorities and healthcare outcomes

• Act as a technical advisor to multiple teams, providing guidance on system design, technology choices, and implementation approaches

• Influence and drive technical discussions across the organization, helping teams navigate complex technical challenges and make informed decisions

• Translate business requirements into technical strategies, ensuring engineering work directly supports Pearl's mission and growth objectives

• Represent the engineering perspective in strategic planning, roadmap prioritization, and resource allocation discussions

Mentorship & Cultural Leadership

• Mentor engineers at Software Engineer I, II, and III levels, accelerating their technical growth and leadership development

• Foster a strong engineering culture focused on continuous learning, technical excellence, and Pearl's Leadership Principles

• Conduct thorough design and code reviews, raising the bar for technical quality and sharing knowledge generously across teams

• Model proactive problem-solving, ownership mindset, and bias for action that inspires others to take on greater technical challenges

• Contribute to hiring, onboarding, and retention efforts, helping build and scale high-performing engineering teams

Delivery & Impact

• Own and drive multi-quarter technical projects with autonomy and accountability, ensuring successful delivery aligned with business timelines

• Identify and resolve systemic issues, technical bottlenecks, and cross-team dependencies that impact delivery velocity or system reliability

• Balance speed and quality, making pragmatic decisions that enable rapid iteration while maintaining engineering excellence

• Measure and communicate the business impact of technical work, connecting engineering outcomes to customer value and organizational goals

What You’ll Bring

We are looking for a seasoned technologist who can seamlessly balance deep technical execution with strategic, organizational leadership. Your experience should reflect a proven ability to lead large-scale projects, elevate team performance, and make technology decisions that directly drive business and healthcare outcomes.

Must-Haves:

• 10+ years of experience in backend or full-stack software development, with a proven track record in service-oriented architectures and large data systems.

• Demonstrated architectural experience designing and implementing scalable, distributed systems, including microservices and event-driven architectures.

• A strong leadership track record in driving technical direction for significant, cross-functional projects.

• Cloud platform proficiency (preferably AWS), including hands-on experience with infrastructure design, deployment pipelines, and cost optimization.

• Deep expertise designing and optimizing data-intensive applications involving large-scale data movement, transformation, and presentation.

• Proven production operations experience in distributed systems, encompassing observability, monitoring, incident response, and operational excellence.

• Experience in aligning technical decisions with business objectives and clearly communicating complex trade-offs to technical and non-technical stakeholders.

Nice-to-Haves:

• Experience building systems in healthcare technology, fintech, or other highly regulated industries with complex compliance requirements.

• Expertise in regulatory compliance with frameworks like HIPAA, SOC2, or similar regulated environments, demonstrating a strong focus on privacy and security.

• Experience leading architectural transformation projects, such as monolith-to-SOA migrations or platform modernizations.

• Frontend architecture experience, including state management, component design systems, build optimization, and deployment strategies.

• Hands-on experience with AI-enabled development using tools like Cursor, Claude, or other productivity tools to accelerate development velocity.

• Deep database expertise with relational databases, including schema design, query optimization, data consistency patterns, and performance tuning.

This role might not be for you if:

• You are seeking a role primarily focused on individual contribution without the desire to mentor or influence the growth of multiple engineers.

• You prefer working on projects with a purely short-term focus rather than driving complex, multi-quarter technical projects with long-term organizational impact.

• You prefer a highly structured, top-down environment where you are not expected to independently identify and resolve systemic issues or cross-team dependencies.

• Your career preference is to specialize deeply in only one area of the stack (pure frontend or pure backend) and not apply expertise across a full-stack context.

• You are unwilling to engage deeply at all technical levels, from strategic architecture down to the implementation details, to fully understand complex systems.

Our Values

🤝 Collaborate to Innovate: We believe the best solutions arise from intelligent teamwork. We trust the expertise of our teammates and pursue opportunities to learn and grow from each other. By embracing diverse perspectives and encouraging authenticity, we create and evangelize groundbreaking health solutions.

🗣️ Trust Through Transparency: We prioritize transparency in all our interactions, ensuring that employees, patients, clinicians and partners have access to the information they need to make informed decisions. Integrity is at the core of how we operate, from building products to fostering relationships, and is crucial to our ability to communicate openly and gain trust.

❤️ Serious Impact, Big Heart: We go above and beyond with our efforts to empower proactive, patient-centered care — and we celebrate every step forward. Humor and positivity fuel our creativity, strengthen relationships, and remind us to acknowledge the journey as much as the destination.

We are an Equal Opportunity Employer on a mission to improve lives. Our strength comes from the diverse backgrounds, experiences, and perspectives of our team. We welcome all candidates and are committed to a fair, inclusive hiring process free from discrimination.

What We Offer

The expected offer for this role includes the following components:

• Base Salary Range: $180,000 - $240,000 per year.

• Additional Compensation: This role is eligible for a discretionary performance bonus and equity options.

• Benefits: We offer a competitive benefits package. You can learn more on our benefits page.

Final compensation for this role will be determined by a variety of factors, including a candidate's relevant skills, experience, labor market conditions, and location.

Agency Submissions

We are not currently working with contingency search firms. If a resume is submitted to any Pearl Health employee by a third party without a valid written and signed search agreement, it will become the property of Pearl Health and no fee will be paid, irrespective of whether the candidate is hired.

The Interview Process

While steps may vary by role, you can typically expect:

1. Recruiter Screen: An intro call to discuss your background and motivations.

2. Technical Exercise: A take-home or live assessment meant to evaluate relevant technical skills.

3. Engineering Manager Interview: A deeper-dive conversation with an EM.

4. Panel Interview: A round of technical and behavioral meetings with teammates, a cross-functional partner, and a leader.

5. Executive Interview: Final conversation(s) with 1-2 of our leaders.