Senior Fullstack Engineer - RCM
Senior fullstack engineer responsible for building and supporting a contract-first clinical operations platform across Vue, TypeScript, Node.js, and MongoDB. Requires 5+ years of web application experience and 3+ years in healthcare revenue cycle management.
About the job
Responsibilities
- Build product screens using the internal component library.
- Design and implement contract-first API routes with schemas shared across frontend and backend.
- Model clinical and revenue cycle data in MongoDB and maintain query performance as collections grow.
- Contribute to shared TypeScript packages used across the monorepo.
- Take features from specification through production and support them after launch.
- Work across the full revenue cycle, from pre-visit clearance through payment.
- Integrate with clients’ EHRs and external systems.
Requirements
- 5+ years building and shipping production web applications.
- 3+ years of healthcare revenue cycle management experience.
- Strong TypeScript experience across the stack.
- Hands-on experience with a modern frontend framework such as Vue or React.
- Backend experience with Node.js, Express, and MongoDB/Mongoose.
- Ability to design scalable queries and schemas for large clinical, patient, and financial datasets.
- Experience working in and improving large existing codebases.
- Experience moving health data between systems, including HL7, FHIR, and EHR connectivity.
- Experience building complex, auditable systems with strong visibility.
- Experience processing financial events and managing transaction states.
- Experience creating configurable state machines and rule engines.
Preferred Qualifications
- Understanding of clinical workflows, care pathways, patient journeys, and practice payment processes.
- Familiarity with the OpenAI API or similar LLM tooling.
- Monorepo experience with tools such as Turborepo or Nx.
- Experience with real-time or streaming applications.
- Experience with durable workflow orchestration such as Temporal, Cadence, or AWS Step Functions.
- Experience with AWS, Azure, or Google Cloud.
- Experience building analytics or reporting on transactional data.
- Experience with EDI/X12, including 270, 271, and 835 transactions.
Work Environment
- Distributed remote team with hybrid offices in NYC and Vancouver.
- Regular and consistent on-site presence is required.
Skills
TypeScript, Vue 3, React, Node.js, Express, MongoDB, Mongoose, Hl7, FHIR, Ehr Connectivity, OpenAI API, Turborepo, Nx, AWS
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