Lead Software Engineer

Remote Lead Software Engineer for a Healthcare Company

Pearl · United States (Remote) · Full-time · Posted 2026-11-04

Workplace: remote

Department: Technical

Description

Work From Anywhere in the US (New York or Houston preferred, relocation assistance available)

Work Schedule: US Timezone (EST/CT) | Overlap with US business hours

About Pearl Talent

Pearl works with the top 1% of candidates from around the world and connects them with the best startups in the US and EU. Our clients have raised over $5B in aggregate and are backed by companies like OpenAI, a16z, and Founders Fund.

Hear why we exist, what we believe in, and who we’re building for:
Watch here: https://www.loom.com/share/863b8e426e6d48309aa8f4ea4c1c94cd

About the Client

A seed-stage US healthcare technology company is building a system to redistribute unused medications to patients who cannot afford them. It is looking for a Founding Senior Full-Stack Engineer to build the products that increase the supply of donated medications.

The company runs a pharmacist-led process that recertifies donated medications for safe reuse. The team is 8 people across two continents. Large health plan contracts are signed or pending, so the company is close to moving from proof of concept to scaled execution.

About the Role

This is a hands-on individual contributor role. You will work directly with the Head of Technology and the CEO, building across a Python/Django and PostgreSQL backend, a React frontend, and AWS infrastructure. Your first project is a donation management platform that lets major health systems donate medications without the current email-based process. Success means health systems donate through the platform instead of email, and the supply of donated medications grows as a result. Remote team members travel to Houston quarterly and to New York for onboarding.

Core Responsibilities

Product Development

• Build the first donation management platform for health systems, replacing the current email-based process
• Own new products for healthcare providers, health systems, and medication supply operations
• Turn 50-state compliance rules, multi-state transfers, and expiration tracking across thousands of SKUs into working business logic
• Partner with the Head of Technology on product direction and key engineering decisions

Engineering Execution

• Design, build, and ship full-stack features from concept to production in React, Django, and PostgreSQL
• Extend the existing codebase and reduce 6–9 months of accumulated tech debt
• Build and maintain integrations with health system, pharmacy, and logistics partners
• Meet HIPAA and PHI data-handling requirements in every feature

Infrastructure and Quality

• Manage AWS infrastructure using CDK and Terraform
• Improve architecture, code quality, and documentation so future engineers can onboard quickly
• Find and fix inefficiencies in existing systems, workflows, and user experience

Founder Collaboration

• Work directly with the CEO on product direction and Figma design handoffs
• Contribute to product and technical planning in a flat, 8-person team
• Set up the technical foundation for a future engineering team

Requirements

Must-Have

• 5+ years of professional software engineering experience, including 2+ years at seed to Series A startups or small, autonomous engineering teams
• Took at least one product or major feature from zero to production as an early engineer
• Full-stack production experience across frontend, backend, and database (Python/Django, React, and PostgreSQL preferred; equivalent modern stacks accepted)
• Hands-on coding in an individual contributor role within the last 2 years
• Public GitHub profile, portfolio, or open-source or side projects available for review
• Based in the United States with current authorization for W-2 employment
• English at C1+ CEFR level

Nice-to-Have

• Experience in healthcare, digital pharmacy, healthtech, logistics, or supply chain
• Built software for HIPAA-compliant or other regulated platforms
• AWS infrastructure experience with CDK or Terraform
• Integrated AI capabilities into a production product or workflow
• Based in, or open to relocating to, New York City or Sugar Land, TX

Benefits

Our Recruitment Process

1. Application
2. Screening
3. Skills Assessment
4. Topgrading Interview
5. Client Interview
6. Job Offer
7. Client Onboarding

Ready to Join Us?

If you’re empathetic, organized, and passionate about improving patient experiences through operational excellence, this role is for you. Apply now to help make specialized healthcare more accessible to patients across the U.S.

Apply

Apply at Pearl

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