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ExactCare

Long-term care pharmacy and medication management

Software Engineer

Full-TimeUpdated on 10/23/2026
No salary listed
Mid
Bachelor's
Remote in USA
Remote
Software EngineeringFull-Stack Engineering
No H1B Sponsorship

About the job

Requirements
  • A bachelor's degree in Computer Science, Information Systems, Engineering, or a related field, or equivalent practical experience.
  • At least 3 years of professional software development experience using Ruby, preferably Ruby on Rails.
  • Full-stack development experience, including front-end development with HTML, CSS, JavaScript, and Rails view or UI technologies, and back-end development with Rails, ActiveRecord, and service or business logic layers.
  • Strong SQL skills, including complex query writing, query optimization, and working with relational database schemas such as PostgreSQL or MySQL.
  • Experience resolving defects in a live production application and performing root-cause analysis.
  • Experience developing new features within an existing, mature codebase.
  • Exposure to software development in a healthcare environment, ideally involving an EHR or other clinical system.
  • Working experience in an agile or Scrum environment, including familiarity with tools such as Jira or Azure DevOps.
  • Experience with automated testing frameworks such as RSpec or Capybara, and Git-based version control.
  • Practical experience using AI-assisted development tools such as GitHub Copilot, Claude, or similar for documentation acceleration, resource development, and code execution.
  • Strong written and verbal communication skills and the ability to work effectively across a cross-functional team.
  • Direct experience working on or supporting an EHR platform, proprietary or commercial, such as Epic, Cerner, athenahealth, or similar.
  • Familiarity with healthcare interoperability standards such as HL7 or FHIR.
  • Familiarity with HIPAA and protected health information handling requirements.
  • Exposure to pharmacy or other clinical workflows.
  • Experience with CI/CD pipelines and modern front-end frameworks or Rails tooling, such as Turbo, Stimulus, or React.
Responsibilities
  • Design, develop, and maintain features on the existing EHR platform using Ruby on Rails across the application's front-end and back-end layers.
  • Build and modify user-facing front-end views and interactions, and implement back-end business logic, services, and data access.
  • Triage, debug, and resolve defects in the production EHR application by performing root-cause analysis and delivering durable fixes.
  • Design and build new features and enhancements within the existing platform architecture, from requirements through implementation and testing.
  • Write, optimize, and troubleshoot complex SQL queries against relational databases, including work involving clinical and patient-related data structures.
  • Participate in sprint planning, daily standups, backlog refinement, sprint reviews, and retrospectives.
  • Commit to and deliver against sprint timelines while collaborating with product owners, QA, and other engineers.
  • Write and maintain automated tests, participate in code reviews, and follow secure coding practices appropriate for a system handling protected health information.
  • Use AI tools to accelerate technical documentation, generate and refactor code, build supporting resources such as test data, scripts, and diagrams, and assist with code execution and validation while appropriately reviewing AI-assisted output.
Desired Qualifications
  • Ruby on Rails experience is preferred.
  • Healthcare software development exposure ideally involving an EHR or other clinical system.

About the company

ExactCare Pharmacy provides medication management for patients on multiple medications, with services like reconciliation, refill management, pre-sorted packaging, and home delivery, especially for long-term care. It coordinates with patients, families, and healthcare providers to review medications, reduce errors, and ensure timely dispensing; packaging groups doses by time to simplify administration and safety, with delivery to patients’ homes. The company stands out through a strong emphasis on patient safety and data security (HITRUST-certified) and by integrating end-to-end medication management within care plans managed by providers and insurers. Its goal is to reduce adverse drug events, improve adherence, and support caregivers and healthcare teams in managing complex regimens.

Company Size

201-500

Company Stage

N/A

Total Funding

N/A

Headquarters

Valley View, Ohio

Founded

2009

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Simplify's Take

What believers are saying

  • AnewHealth launched in July 2024, sharpening the story for payer and provider sales.
  • HomeFree joined in July 2024, expanding reach to nearly 110,000 people nationwide.
  • ExactCare's decade-plus Medicare-plan relationships support renewals and cross-sell into PBM services.

What critics are saying

  • The NFB lawsuit over inaccessible prescription formats threatens damages and compliance changes.
  • AnewHealth integration after the 2023 merger risks service disruption and duplicated costs through 2026.
  • Private-equity ownership under Nautic and Vistria demands growth, or a 2026 recapitalization squeeze.

What makes ExactCare unique

  • ExactCare targets patients with complex chronic needs, not commodity retail prescriptions.
  • AnewHealth combines ExactCare, TRHC, and CareVention into pharmacy care management.
  • Proprietary medication therapy optimization plus national dispensing create switching friction for health plans.

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Benefits

  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • 401(k) Retirement Plan
  • Paid Vacation
  • Paid Holidays
  • Health Savings Account/Flexible Spending Account

Growth & Insights and Company News

6 month growth

7%

1 year growth

7%

2 year growth

7%
ExactCare Pharmacy
Apr 23rd, 2024
ExactCare Wins 2024 Top Workplaces Awards

This is the second consecutive year ExactCare has been named to Top Workplaces USA.

The Business Journals
Nov 9th, 2023
ExactCare adding tech, pharmacy benefits management with business combination

John Figueroa, who previously served as executive chairman of ExactCare, has been appointed chairman and CEO of the combined company, ExactCare said upon the deal's closing.

ROI-NJ
Nov 1st, 2023
Tabula Rasa Healthcare Stockholders Give Thumbs-Up For Acquisition By Nautic Partners

Tabula Rasa HealthCare on Tuesday said its stockholders approved the previously announced acquisition by Nautic Partners.The proposal to adopt the merger agreement was approved at a virtual special meeting of the Moorestown-based company’s stockholders held Tuesday, with approximately 99.6% of the votes cast in favor of the proposal, which represented approximately 70.9% of the outstanding shares of company common stock.As a result of the approval, the company will combine with ExactCare Pharmacy, a portfolio company of Nautic.“We are happy to have the strong support of Tabula Rasa’s stockholders, who recognize the value of bringing us together with Nautic’s ExactCare portfolio company to advance our ability to partner with risk-bearing health care organizations serving those with complex care needs,” Brian Adams, CEO and president of TRHC, said. “This combination will extend our reach and position us to take advantage of existing and emerging opportunities within and adjacent to our core PACE market.”The company expects to complete the transaction during the fourth quarter, and upon closing, it will become privately held

Seeking Alpha
Aug 7th, 2023
Tabula Rasa going private; will merge with ExactCare Pharmacy

Tabula Rasa going private; will merge with ExactCare Pharmacy.

ExactCare Pharmacy
Mar 15th, 2023
ExactCare Sponsors Upcoming World Kidney Day Event

ExactCare has partnered with KFO for more than a decade to provide support for people living with kidney disease, including through programs that improve access to medications.