Principal Engineer
Fuze Health· Healthcare IT· Oct 13, 2026 · 15d ago
Remote Texas
Hybrid
Full-time
Principal
$216K–$270K
10+ years exp
Job description
Job Summary
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.
Additional Information
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 light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.
Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Fuze Health’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.
Salary Range: $215,840 to $269,800
Commission Eligible: No
Incentive/Bonus Eligible: Yes
Equity Eligible: Yes
Location Requirement:
FuzeRx (Truepill / Fuze Care Services) is limited to individuals residing in the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington (WA), Wisconsin.
Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. Alto Pharmacy, Fuze Health, LetsGetChecked, and Fuze Care Services can not take over, transfer, or sponsor any visa type at this time.
Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&D) insurance, flexible spending account (FSA) and health savings account (HSA), commuter benefits, employer-paid short-term (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, home health testing kits, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 10 paid holidays, (2 floating holidays for full time non-exempt employees) , and eight weeks of paid parental leave for eligible employees, additional paid weeks for the birthing parent, 4 weeks paid caregiver leave, and a Lifestyle Spending Account allowance each month.
More Benefits Information Here: Fuze Health Benefits Site
At Fuze Health, we are committed to fostering an inclusive environment that celebrates diversity in all its forms. We believe that the diversity of thought, background, and experience strengthens our teams and drives innovation. We are an equal-opportunity employer and do not discriminate on the basis of race, ethnicity, religion, color, place of birth, sex, gender identity or expression, sexual orientation, age, marital status, military service status, or disability status. Our goal is to ensure that everyone feels valued and empowered to thrive.
Fuze Corporate Inc. and its subsidiaries respects your privacy and is committed to protecting your personal information. Please read our Candidate Privacy Notice which explains how we collect, use, disclose, and protect personal information about job applicants during the recruitment and hiring process.
Security Notice : Individuals are impersonating Fuze Health recruiters and executives. Verify all communications originated from fuzehealth.com.
Learn more here
Equal Opportunity Employer
Fuze Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at talent fuzehealth.com .
Fuze Health considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, Philadelphia, and New York City Fair Chance laws. We are an E-Verify participating company.
Use of Automated Decision Tools
Fuze Health recruiters and hiring managers may use automated decision tools to help identify candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. Fuze Health does not use automated decision tools to make hiring decisions; hiring decisions always involve human review and input. If you have any questions or would like to request an alternative process, please contact us a t talent fuzehealth.com .
Privacy Notice
To learn about Fuze Health’s privacy practices, including compliance with applicable privacy laws, please read our Privacy Notice for Job Applicants .
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Benefits
Benefits detected in the listing.
Dental
Vision
401(K)
Parental Leave