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Principal Software Engineer

Prescryptive Health

Prescryptive Health

Software Engineering
United States · Colorado, USA · Maryland, USA · California, USA · Massachusetts, USA · Pennsylvania, USA · Virginia, USA · Illinois, USA · Texas, USA · Oregon, USA · Florida, USA · Michigan, USA · Washington, USA · Indiana, USA · North Carolina, USA · Georgia, USA · Delaware, USA · Tennessee, USA · Arkansas, USA · New Jersey, USA · Connecticut, USA · Vermont, USA · Louisiana, USA · New Hampshire, USA · South Carolina, USA · Wisconsin, USA · Missouri, USA · Ohio, USA · Wyoming, USA · Kansas, USA · Arizona, USA · North Dakota, USA · Hawaii, USA · Nevada, USA · Iowa, USA · Oklahoma, USA · Mississippi, USA · West Virginia, USA · Nebraska, USA · Minnesota, USA · Alabama, USA · Idaho, USA · South Dakota, USA · New Mexico, USA · Utah, USA · Maine, USA · Rhode Island, USA · Alaska, USA · Montana, USA · Porto, Portugal · New York, NY, USA · Washington, DC, USA · Remote
USD 155k-215k / year + Equity
Posted on Apr 3, 2026

Who is Prescryptive?

Prescryptive is the healthcare technology company enabling the direct access marketplace for prescription drugs. Our platform aligns incentives so affordability, choice, and patient access become the natural outcome of a functioning system. Learn more about us by following us on LinkedIn or visiting Prescryptive.com.

About this role

As a Principal Software Engineer, you'll shape how the organization builds software. That means setting technical direction across teams, making architectural bets with lasting impact, and ensuring the organization focuses its energy on the problems that matter most. Your impact will show up in the systems you build, the quality of technical decisions across the organization, the alignment you create between teams, and the clarity you bring to complex problems.

You'll work directly with engineering leadership, domain leads, and technical product managers to connect technical strategy to business outcomes. This is one of a small number of roles shaping the company's technical future, and it requires someone who can walk into an unclear situation and leave it with a clear technical path forward.

What you will do

  • Elevate the technical judgment of engineers around you through design reviews, architectural guidance, and mentorship
  • Troubleshoot and drive resolution of the hardest cross-system issues in our stack
  • Participate in on-call rotation to ensure system reliability and rapid issue resolution
  • Engage directly with product and executive stakeholders to assess feasibility, cost, and risk of strategic initiatives
  • Drive architectural decisions and technical direction across multiple teams and systems
  • Directly build and ship software that tackles the hardest, most ambiguous technical problems in our stack
  • Set the engineering standard through your own code, design patterns, and technical approach
  • Own cross-cutting concerns: scalability, reliability, security posture, and cloud cost efficiency
  • Identify converging efforts across teams and consolidate before they become compounding tech debt
  • Design and evolve system architectures for our B2B portals, collaboration tools, internal platforms, and customer-facing APIs
  • Evaluate build-vs-buy decisions, technology bets, and system design tradeoffs with direct business impact

What you will bring

  • 10+ years of software development experience, having progressed from shipping great software to shaping how organizations approach building it
  • Deep architectural experience designing systems that span multiple services, teams, or domains
  • Exceptional hands-on engineering skills across the full stack, with the ability to go deep on the hardest problems in any part of the system
  • Strong proficiency across multiple languages and comfortable ramping quickly on ones you haven't used before. Our stack includes Go, TypeScript, C#, and React.
  • Proven ability to own the full software development lifecycle, from requirements and design through construction, testing, deployment, and production operations
  • Experience with cloud architecture and resource-efficient infrastructure design at scale
  • Full ownership mentality that extends beyond your own code to the health of systems, culture, and teams around you
  • Strong understanding of SQL databases, caching layers, event-driven architectures, and data pipeline design
  • Pragmatic technical judgment that optimizes for the right solution given real constraints, not the theoretically perfect one
  • Track record of driving technical alignment across teams with competing priorities
  • Enthusiasm for leveraging AI-assisted development tools and emerging technologies
  • Ability to translate between business language and technical language fluently, in both directions
  • Must have permission to work in the US on a permanent basis

Ideally you’ll also have

  • Experience with healthcare data standards (HL7, FHIR) or regulated industry environments
  • Experience with GraphQL, event-driven data pipelines, or healthcare integration patterns (EHR, PMS, PBM)
  • Advanced DevOps and platform engineering experience including Infrastructure as Code, containerization, and observability at scale

What we have to offer

  • The opportunity to grow alongside an early-stage company shaking up a big, old-fashioned industry
  • Flexible time off, including 12 paid holidays
  • 401k match plus 100% employer paid medical, dental, and vision premiums
  • Company contribution to Health Savings Account
  • Stock options

Prescryptive is committed to fair pay practices. The projected annual salary for this position is $155,000 to $215,000. When preparing an offer, we consider the candidates resume, experience, interview feedback, internal equity, and location.

Prescryptive is an Equal Opportunity Employer. Prescryptive does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, merit, and business need.