Principal Engineer
Fuze Health · Remote
📍 Remote, United States💰 $209,600 - $262,000via greenhousePosted 2026-06-03
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At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments – and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs.
Fuze Health’s foundation is built upon the strategic combination of several proven, technology-powered innovators in the digital health, diagnostics, and pharmacy sectors. Our growing portfolio brings together the capabilities of industry leaders including LetsGetChecked, Truepill, and Alto Pharmacy, to create a distinctive, unified force in healthcare. Together, we have the shared vision, advanced capabilities and talented teams to deliver next-generation solutions that patients and healthcare partners need today and into the future.
Job Description:
As a Principal Engineer at Fuze Health/FuzeRx, you are a top-tier technical leader and individual contributor who drives the overarching technical vision and architectural strategy across our engineering organization. Reporting to the VP of Engineering, you will operate across multiple product squads, guiding the design and execution of our most complex, mission-critical systems. By setting the standard for engineering excellence and leveraging our core stack ( AWS, PostgreSQL, Ruby on Rails, Python, and TypeScript/JavaScript ), you will ensure our digital pharmacy, API-powered fulfillment, and patient care platforms are highly scalable, performant, and secure. This role is essential to our mission, directly enabling FuzeRx to process high volumes of healthcare transactions reliably while maintaining strict compliance and improving patient outcomes.
Key Responsibilities:
Architectural Vision & Strategy: Define and evolve the target architecture for FuzeRx’s core B2B and consumer platforms. Drive the technical roadmap to transition legacy systems into modern, scalable, and highly cohesive architectures.
Complex Problem Solving: Lead the design and implementation of the most technically challenging initiatives, such as high-volume API integrations, complex pharmacy fulfillment logistics, and distributed data consistency.
Technical Mentorship & Leadership: Serve as a mentor and force multiplier for Staff, Senior, and Mid-level engineers. Elevate the engineering culture by instituting rigorous design reviews, pairing sessions, and technical brown-bags.
Standards & Best Practices: Establish and enforce engineering standards across the organization, including coding guidelines, testing frameworks, CI/CD pipeline strategies, and security-by-design principles.
Cross-Functional Partnership: Collaborate deeply with Product Management, Engineering Managers, and Pharmacy Operations to ensure technical architectures align with long-term business goals and clinical requirements.
Regulatory & Security Compliance: Partner with the InfoSec team to architect systems that natively support strict healthcare compliance standards (HIPAA, SOC2), ensuring patient data privacy and secure messaging.
Performance & Reliability: Spearhead initiatives to optimize system performance, reduce latency, and improve database efficiency within our PostgreSQL and AWS infrastructure.
Technology Evaluation: Continuously evaluate new tools, frameworks, and AWS services, running proof-of-concepts (POCs) to determine their viability for improving the FuzeRx ecosystem.
Required Experience & Qualifications:
Education: Bachelor’s degree in Computer Science, Software Engineering, or a related technical discipline.
Experience: 10+ years of progressive, hands-on experience in software engineering and systems design. 3+ years operating at a Staff, Principal, or equivalent senior architectural level, driving technical initiatives across multiple teams.
Industry Experience: Extensive background in building and scaling distributed, high-throughput, and highly available B2B SaaS or transactional systems.
Shift / Site Specific Requirements: Standard business hours; expected to serve as a Tier 1 technical escalation point for critical architectural outages. [Insert Remote/Hybrid/On-site details].
Tools & Tech Stack: Mastery of modern cloud architectures and demonstrable, deep, hands-on expertise in AWS , PostgreSQL , Ruby on Rails , Python , TypeScript , and JavaScript . Familiarity with standard corporate tools (Slack, GSuite, Jira).
Other Desired Experience: Exceptional communication skills with the ability to explain complex technical trade-offs to non-technical executives and stakeholders. A strong bias for action and pragmatism over architectural purity.
Measurable Expertise: Proven ability to design and implement complex distributed systems, optimize complex relational database queries, and establish automated deployment pipelines.
Preferred Qualifications:
Education: Master’s degree in Computer Science, System Engineering, or related field.
Other Desired Experience: Active contributions to the open-source community or experience speaking at technology conferences.
Specific Required Expertise: Deep domain expertise in HealthTech, Digital Pharmacy, or highly regulated environments.
Advanced knowledge of healthcare data interoperability standards (e.g., HL7, FHIR, NCPDP) and electronic health record (EHR) integrations.
Experience leading a major architectural paradigm shift (e.g., monolith to microservices or event-driven architecture) at scale.
Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move li
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