Senior Full-Stack Engineer

Location Philadelphia, PA, or Remote (EST hours preferred) Overview Highlight Health is a mission-driven company that protects consumer rights and controls healthcare costs exclusively for self-funded employers and their stop loss carriers. We are a profitable, fast-growing company. We are currently upgrading our core operations into a sophisticated, proprietary Claims Intelligence Platform. This isn't a prototype; it is an innovative system of record handling protected health information (PHI) and generating financial recommendations with real-world legal and economic weight. Highlight Health engineers new ways to protect consumer rights and control healthcare costs for self-funded employers. Nearly every American has felt the pain of the skyrocketing cost of healthcare. Highlight Health brings them solutions. We use our subject-matter expertise to reduce costs for employers and relieve ordinary Americans of burdensome medical costs. Highlight Health is proud of its inclusive workplace that brings together highly skilled leadership and employees from all walks of life. We are looking for a Senior Full-Stack Engineer to be a strong, experienced builder on this platform team. We are looking for someone who can pick up complex features independently, mentor less-experienced engineers, and step in to help with code review when the team needs the coverage. Our team is a lean group of domain experts who know healthcare claims deeply, building features in parallel using AI-assisted development as the default way of working, not an occasional convenience. At Highlight Health, the output of your work matters. You'll be building on a platform where the “correctness bar” is exceptionally high, because the results directly affect what employers pay for healthcare. If you want to build fast with AI, bring real depth to a small team, and grow into more review and mentorship responsibility over time, we would love to hear from you. Essential Duties and Responsibilities Build features end-to-end across backend services and the React frontend, using AI-assisted development and spec-driven workflows as your primary mode of work. Write certain core component logic by hand rather than relying on AI generation, particularly for financial calculations and validation logic that must be deterministic, auditable, and correct. Review pull requests with genuine architectural and security judgment, providing backup review coverage alongside our lead engineer as workload requires. Mentor less-experienced engineers on the team through pairing and code review. Apply sound judgment about when AI-assisted development tools are and aren't appropriate, especially for anything touching sensitive data. Escalate architectural decisions with broad impact to the lead engineer or CTO rather than resolving them unilaterally. The Technical Stack Backend: Python, FastAPI, async SQLAlchemy, Alembic migrations. Database: Azure Database for PostgreSQL, row-level security enforced at both application and database layers. Infrastructure: Azure Container Apps (dev/staging/prod), Azure Service Bus for async job processing, Azure DevOps CI/CD, Azure Blob Storage. Frontend: React SPA for the internal application. AI-Assisted Development: agentic coding tools and spec-driven workflows as the team's default; AI-assisted document extraction and OCR pipeline for claims intake. Quality: pytest, automated linting, automated module boundary enforcement in CI. Experience and Qualifications 5-8 years in full-stack engineering, with real depth in both backend and frontend work. Technical depth: Python and PostgreSQL are your core stack in production. You understand async patterns, database-level security, and migration discipline. Full-stack capability: you can review a React pull request and catch both structural problems and data exposure risks. Real, hands-on experience building with AI-assisted coding tools daily, and good judgment about when to override them. Regulated environments: you understand the nuances of working with sensitive data (HIPAA, SOC 2, or PCI) and prioritize audit trails and data access controls. Comfortable being a strong senior contributor without needing to be the most senior voice in the room. Healthcare or fintech background is a genuine advantage — this platform produces recommendations that affect what employers pay for healthcare. Compensation and Benefits Competitive salary based on experience. Highlight Health offers an attractive benefits package, including healthcare cost reimbursement, paid time off, commuting benefits, short-term disability, an employer 401(k) contribution, and bonuses. If you are based in the Philadelphia area, you will have the option of working in-office on a flexible schedule.