Principal Software Engineer (Fullstack)

Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the healthcare ecosystem, driving up costs for plans, providers, and patients alike. We’re here to change that paradigm.

Alaffia is a new kind of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently better outcomes across the entire lifecycle of claims. With Alaffia, health plans can cut wasted spending more effectively than ever — and provide their members the most affordable care.

We’re a high-growth, venture-backed Series B healthtech startup based in NYC and are actively scaling our company. Join us in helping to build a healthcare system that works better for everyone.

*This position requires current authorization to work in the United States. Unfortunately, we are not in a position to sponsor work visas at this time.

We are seeking an exceptional Principal level Engineer to join our product engineering organization and drive transformative impact across our platform. At these levels, you will be responsible for solving complex technical challenges that span multiple teams, defining architectural standards, and shaping the technical direction of our product engineering organization. You will work on the most critical and ambiguous problems facing our business, translating strategic objectives into coherent technical roadmaps, leading and executing on the technical roadmaps to achieve the business outcome. You will leverage cutting-edge AI coding tools to optimize development workflows, mentor senior engineers, and serve as a force multiplier for the entire engineering organization.

• Design and architect systems that affect large parts of the business, ensuring scalability, maintainability, and performance

• Own the technical design and delivery of complex projects involving multiple systems or critical infrastructure

• Make key technical contributions that set direction for how the team writes code, designs systems, and uses core libraries

• Simplify complex problems, enabling teams to achieve more with less effort

• Create substantial improvements in stability, performance, and scalability across the platform

• Identify, formalize, and deliver solutions that impact the entire engineering organization

• Work cross-functionally with business and product partners to influence technical and business decisions

• Set strategic direction for significant portions of the technology stack

• Anticipate potential problems in major projects and devise effective solutions to mitigate them

• Facilitate cross-team collaboration, driving decisions among groups with disparate interests

• Champion the adoption of AI coding tools (Claude Code, GitHub Copilot, Cursor, etc.) to accelerate development velocity

• Establish best practices for leveraging AI assistants in code generation, review, and refactoring

• Optimize development workflows by integrating AI tools into the engineering lifecycle

• Measure and demonstrate productivity improvements from AI-augmented development practices

• Mentor senior engineers and be a force multiplier for the entire team

• Provide technical guidance with a proven track record of sound judgment

• Influence without formal authority, securing cross-team buy-in for technical initiatives

Code Fluency

• Write highly robust, scalable code that is flexible, reusable, efficient, and adaptable to changing requirements

• Provide high-quality code review feedback and foster effective, collaborative code review culture

• Strong awareness of technologies and ecosystems, able to introduce new ideas to solve business and technical problems

• Proficiency with AI coding tools (GitHub Copilot, Cursor, ChatGPT, etc.) to accelerate development

• Responsible for successful project delivery including planning, risk management, design, development, testing, rollout, and maintenance

• Find ways to simplify application code/infrastructure and improve developer efficiency

• Write libraries and modules that can be extended and adopted across the organization

Software Design

• Design software components that are difficult to misuse and flexible for adjacent use cases

• Reduce complex designs to simple foundational components through correct data structures and algorithms

• Create simple interfaces to complex underlying systems

• Review designs across related areas with high quality, ensuring quality for cross-team/cross-module design and API issues

• Deep expertise in implementation or principles behind libraries, platforms, and systems

Architecture Design

• Make correct technology choices for components, including build vs. buy decisions and framework selection

• Own overall health and engineering quality of systems or collections of features

• Drive overall testing strategy for systems with high reliability or quality requirements

• Design systems with significant ambiguity and/or many dependent systems

Technical Strategy

• Ensure alignment of software and systems to overall technical strategy

• Make appropriate tradeoffs in consultation with engineering leaders

Business Acumen

• Leverage fluency in Alaffia Health's business, products, customers, and strategy to identify opportunities

• Understand how strategy and business priorities inform and guide team priorities

Required Experience & Qualifications

• 15+ years of software engineering experience with demonstrated technical breadth and depth

• Proven track record of delivering complex, high-impact projects affecting multiple teams for enterprise SaaS applications

• Proven ability to define and execute technical vision and strategy at scale

• Expert-level proficiency in TypeScript, Python, GraphQL, and PostgreSQL

• Experience with AI coding assistants and demonstrated ability to improve team productivity through their adoption

• Deep understanding of full-stack web development, system design, and cloud infrastructure (AWS preferred)

• Experience with DevOps practices, CI/CD pipelines, and containerization (Docker, Kubernetes)

• Strong project management skills with ability to break down complex projects into milestones

• Excellent communication skills with ability to influence without formal authority

• Experience mentoring senior engineers and driving technical standards

• Deep expertise in healthcare technology and regulatory compliance (HIPAA, HITRUST) preferred

Preferred Qualifications

• Experience building SaaS applications in the healthcare sector

• Track record of building and deploying user-facing AI products

• Experience with AI/ML model deployment and integration

• Contributions to open source projects or technical publications

• Experience with medical billing, healthcare administration, or clinical workflows

Our Culture

Alaffia was born out of our founders’ personal connection to the inefficiency of the U.S. healthcare system. We are deeply mission-driven, with an abiding belief that technology can help create a better future for everyone — and we’re looking for others who share our passion for change to join the team.

• Competitive compensation package (cash + equity)

• Medical, Dental and Vision benefits

• Flexible, paid vacation policy

• Work in a flat organizational structure — direct access to Leadership