Senior Full-Stack Product Engineer

About Bluestone Health

Bluestone Health is building a more connected healthcare experience for employer groups and communities, including people in rural and remote areas where access to coordinated care is often limited. Our model brings together health plan administration, pharmacy benefits, primary care, specialty care, and care coordination so members are not left to navigate a fragmented system on their own.

We are using software, data, and responsible AI to make that model work at scale. That includes connecting systems that rarely communicate well, helping care teams identify what needs attention, reducing administrative work, and giving members a clearer path through their care. Our goal is not to add another digital layer to healthcare. It is to help rebuild how healthcare is organized and delivered so it feels coordinated, responsive, and human.

Our engineering team is small and high-trust. Engineers here have real ownership over systems that directly affect patient care and operations. There are no layers of middle management and no ticket factory. You will work on meaningful problems with significant autonomy, and your work will have a tangible impact on how healthcare gets delivered.

Why Now

Healthcare has no shortage of software, but much of it sits inside disconnected organizations and workflows. The harder problem is making the whole system work together around the member.

Bluestone is at a point where that problem is becoming an engineering opportunity. As we expand, we are building the products, integrations, data foundation, and AI-assisted workflows needed to support a genuinely coordinated model of care. Engineers who join now will help define those systems rather than inherit a finished architecture or spend their time maintaining a narrow feature area.

The Role

We are looking for a Senior Full-Stack Product Engineer to join our engineering team, reporting directly to the CTO. You will own meaningful product areas across Bluestone's applications, with our internal clinical portal and external client portal as your primary product surfaces.

Those portals are important parts of the role, but they are not its limits. The work is genuinely full-stack. You will build user-facing workflows, backend services, data models, integrations, and cloud infrastructure, then support what you ship in production.

You should be able to pick up a problem, understand the user and operational need, evaluate the tradeoffs, and drive it through implementation without waiting for every decision to be turned into a ticket. We are looking for someone who has already shipped dependable production software and wants broad ownership in a small, capable team.

You will also help explore where generative AI can make healthcare easier to navigate and operate. That may include helping care teams find relevant information, reducing repetitive coordination work, turning complex data into usable next steps, or creating more responsive member experiences. We are interested in practical systems that improve human decisions and service, not AI demonstrations looking for a problem.

Why This Role Exists

Bluestone is growing. We have more users, clients, workflows, integrations, and production systems to support. We need a senior engineer who can independently own product delivery while helping the team keep its systems reliable and maintainable.

What that means for you: You will have broad exposure to the full lifecycle of healthcare software, including product discovery, user interfaces, backend services, cloud infrastructure, integrations, data workflows, and production operations. You will have room to influence both the products we build and how the engineering team builds them.

What You'll Work On

• Full-Stack Application Development: Build and maintain applications using React on the frontend and TypeScript and Node.js on the backend.
• Clinical and Client Products: Own features and product areas within our internal clinical portal and external client portal. Work with clinical, operational, and business users to understand how the software needs to support real workflows.
• Connected Member Experiences: Build products that make the different parts of a member's healthcare journey feel more coherent, even when the underlying systems and organizations are fragmented.
• AI-Assisted Healthcare Workflows: Build carefully designed AI-assisted features that help clinical and operational teams understand information, coordinate work, and respond more effectively. Design for human review, privacy, traceability, and safe failure behavior.
• Workflow Intelligence: Use software, data, and automation to surface the right information and next action without removing the judgment of the clinicians and operators accountable for the outcome.
• End-to-End Product Delivery: Turn incomplete requirements into clear, usable solutions. Make thoughtful decisions about interface behavior, backend design, data models, permissions, validation, and operational support.
• Healthcare Integrations: Build and maintain integrations with EHR systems, scheduling platforms, lab systems, TPAs, PBMs, enrollment systems, and third-party healthcare APIs. This is messy, real-world integration work, not a collection of perfectly documented REST APIs.
• Data Pipelines and Automation: Build and maintain data flows that support patient eligibility, claims, census collection, enrollment, care operations, and related workflows.
• Cloud Infrastructure: Deploy and operate serverless and containerized infrastructure on AWS, including Lambda, ECS, S3, RDS, SQS, and CloudWatch. Our infrastructure framework is SST.
• Security and Reliability: Build appropriate permissions, auditability, testing, monitoring, alerting, and failure handling into production features.
• Production Ownership: Monitor and support the systems you ship, investigate failures, participate in incident response, and improve systems based on what happens in real use.
• Engineering Collaboration: Participate in architecture discussions, design and code review, and improvements to shared components and engineering practices.

Current Technical Environment

Our current environment includes:

• React
• TypeScript and Node.js
• PostgreSQL
• AWS, including Lambda, ECS, S3, RDS, SQS, and CloudWatch
• SST and infrastructure-as-code practices
• APIs, file-based integrations, and event-driven processing

You do not need prior experience with every listed service. You do need strong full-stack fundamentals and enough cloud experience to own production features rather than handing them off after the code is written.

What We're Looking For

Required

• Senior-level professional software engineering experience building, shipping, and operating production web applications.
• Strong TypeScript or JavaScript proficiency across frontend and backend development.
• Production experience with React or a comparable modern frontend framework.
• Backend development experience with Node.js or a comparable server-side environment.
• Strong relational data modeling and SQL skills, preferably with PostgreSQL.
• Experience deploying and supporting applications in AWS or another major cloud platform.
• A record of owning meaningful features or product areas from problem definition through production operation.
• Ability to work directly with users and stakeholders, ask useful questions, and make progress when requirements are incomplete.
• Sound product and engineering judgment, including the ability to balance user experience, delivery speed, maintainability, security, and operational risk.
• Experience with testing, monitoring, debugging, and incident response for systems used by real customers or internal operators.
• Clear written and verbal communication in a remote environment.
• Ability to work independently in a small team and drive work to completion without constant task-level direction.
• Residence in the United States, Canada, or Latin America, with substantial working-hour overlap with the U.S. team.

Strongly Preferred

• Experience building internal operations software, customer portals, case-management tools, clinical workflows, or other complex role-based applications.
• Experience connecting systems through APIs, webhooks, file feeds, or event-driven processing.
• Familiarity with infrastructure as code, serverless systems, or containerized workloads.
• Experience with design systems, accessible interfaces, and responsive application design.
• Experience using product analytics and operational metrics to improve workflows after launch.
• Experience in healthcare, insurance, benefits administration, fintech, or another regulated environment.

Nice to Have

• Familiarity with healthcare eligibility, enrollment, claims, billing, or clinical workflows.
• Experience with HIPAA, protected health information, audit logging, consent, or role-based access controls.
• Experience with EHR or EMR systems such as Elation, Epic, Athenahealth, or similar platforms.
• Experience in a small engineering team or startup environment.

How We Work

• Ownership, not tickets. Engineers own systems and outcomes, not just assigned code changes.
• Start with the user. A technically correct feature is not successful if it creates a broken clinical or operational workflow.
• Make tradeoffs explicit. We expect engineers to explain what a faster or simpler approach gains and what it gives up.
• Build for production. Security, observability, recoverability, and supportability are part of delivery.
• Communicate directly. Raise unclear requirements, blockers, risks, and unrealistic timelines early.
• Use AI ambitiously and responsibly. We use AI in our engineering work and are building AI-assisted healthcare workflows where it can meaningfully improve access, coordination, and service. AI supports people rather than replacing accountable judgment. Engineers remain responsible for understanding the problem and for the security, correctness, safety, and maintainability of what they ship.

Why This Role

• Meaningful ownership. You will own real systems and product areas rather than working through an endless backlog of disconnected tickets.
• Mission that matters. The software you build directly supports clinical teams, clients, and members.
• Work on the hard part of healthcare. Help connect benefits, pharmacy, clinical care, and coordination into one operating model rather than building another isolated point solution.
• Small team, high trust. You will work closely with decision-makers and end users, without layers of bureaucracy.
• Broad technical scope. You will work across product development, integrations, infrastructure, and production operations.
• Room to shape the team. You will help improve both the product and the engineering practices as Bluestone grows.
• Build with AI without the theater. Explore meaningful uses of generative AI in healthcare while working in a company that values engineers as problem solvers, system owners, and accountable decision-makers. We use AI to expand what strong teams can accomplish, not as a rationale to eliminate the team.

Security and Compliance

This role may involve systems that process protected health information and other sensitive data. The selected engineer must complete required security, privacy, and HIPAA training, follow Bluestone's access and security policies, and work only through approved devices and access methods.

Expected Hiring Process

1. Application or recruiter introduction: Resume and brief background information.
2. Screening conversation: Background, role alignment, working hours, and mutual questions.
3. Practical technical assessment: A paid, asynchronous exercise based on realistic work rather than algorithm puzzles.
4. Technical deep dive: Review the assessment and discuss architecture, implementation decisions, and production tradeoffs.
5. Final conversation: Remaining questions, logistics, and offer discussion.

We aim to complete the interview process in approximately two weeks once interviews begin.

How to Apply

Send your resume and a brief note. In your note, tell us:

• Why this role interests you.
• About a product, feature, or system you have built and are proud of.
• Your location, time zone, and availability.

We review applications personally. We do not use automated keyword screening to decide who gets considered.

Equal Opportunity

Bluestone Health is committed to providing equal employment opportunities without discrimination or harassment on the basis of race, color, religion, sex, gender, sexual orientation, gender identity, national origin, disability, age, veteran status, or any other status protected by applicable law.