We're looking for a hands-on Principal Engineer to lead the design and delivery of our backend—built on TypeScript + NestJS—and help our small team iterate quickly with confidence. You'll turn ambiguity into shippable slices, help set technical direction, and raise the bar on reliability, security, and speed. Responsibilities include owning the backend, architecture stewardship, establishing testing strategy, ensuring observability, raising the engineering bar, and partnering with product and domain experts. Requirements include 8+ years building production systems, deep TypeScript + Node.js and expert-level NestJS in production, and a track record leading cross-team projects. Bonuses include FHIR/Medplum, healthcare data workflows, HIPAA/SOC 2 experience, and comfort with modern frontend (React/Next.js).
