{"id":599481,"url":"https://alion.io/job/alpacahealth-senior-full-stack-software-engineer","title":"Senior Full-Stack Software Engineer","company":{"id":668674,"name":"Alpaca Health","domain":"alpacahealth.io","url":"https://alion.io/company/alpacahealth","size_band":"501-1000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Ashby","truth_index":{"grade":"C","score":65,"open_postings":365,"ghost_share":0.589,"stale_share":0,"repost_share":0.008,"time_to_fill_p50_days":26,"computed_at":"2026-10-31T05:58:55Z"}},"role":"Backend","role_family":"Backend","seniority":"senior","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["New York, United States","San Francisco, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":200000,"max":250000,"currency":"USD","period":"year","gross":null,"usd_annual":250000},"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"LLM","optional":false}],"status":"live","first_seen_at":"2026-04-09T22:43:46Z","employer_posted_date":"2026-04-09","last_verified_at":"2026-10-31T08:06:32Z","board_verified":true,"closed_at":null,"days_open":204,"trust":{"level":"ghost","repost_count":0,"flags":["stale","company_stale"],"days_open":204},"description":"About Alpaca Health\nAlpaca Health enables clinicians to become entrepreneurs, starting in autism care.\nWe help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: use technology to make business ownership possible for every passionate provider.\nWe've raised over $14M in funding from early-stage investors like Core Innovation Capital, Adverb Ventures, and South Park Commons, and are building for long-term category leadership. More importantly, we're serving hundreds of patients, while growing 30% MoM.\nThis role is full-time. We’re looking for candidates based in New York City or San Francisco, excited about a 5 days in-office culture.\nBoth founders are technical. Every engineer on the team has experience at early-stage startups. Several have built products from zero to scale, and one previously founded a YC-backed company.\nWe care deeply about engineering quality, ownership, and building systems that correctly model reality. We do not have layers of management, architecture committees, or roadmap bureaucracy. Engineers talk directly to customers, make technical decisions, and ship.\nRole: Senior Software Engineer\nWe're a tiny engineering team building something large. You'd be the person who owns the platform foundation - the data models, the money logic, the state machines, the API contracts, the AI infrastructure. Not \"owns\" in the sense of reviewing PRs. Owns in the sense of: you designed it, you built it, you stand behind it.\nOne day you're designing a schema migration strategy. The next you're building an LLM pipeline for clinical documentation. The day after that you're debugging a billing edge case that only appears when Colorado Medicaid is the secondary payer.\nThis isn't a job for someone who wants to specialize. It's a job for someone who gets uncomfortable when critical business logic lives in someone's head instead of in code.\nWhat You’ll Own\nAI-Native Clinical Workflows\nWe're rethinking healthcare software from the ground up with AI built into the core experience. You'll help build products that assist with clinical documentation, treatment planning, reassessments, supervision, and administrative work, giving providers more time to focus on patient care.\nRevenue & Payments Infrastructure\nHealthcare is ultimately a complex flow of money. You'll own systems that determine how services are authorized, billed, adjudicated, and paid, ensuring providers get paid accurately and on time while maintaining trust in the platform.\nProvider Business Operations\nStarting a healthcare practice today is painfully manual. Build the tools that make credentialing, contracting, compliance, payroll, scheduling, and staffing feel effortless, allowing clinicians to focus on growing their practices instead of managing paperwork.\nPatient & Family Experiences\nDesign the products families interact with throughout their care journey, from intake and onboarding to scheduling, communication, progress tracking, and payments. You'll help create experiences that make accessing care dramatically easier.\nInternal Automation Systems\nMuch of healthcare still runs on spreadsheets, inboxes, and manual workflows. You'll build software and AI systems that automate operational work across credentialing, billing, authorizations, and care coordination, enabling a small team to support thousands of providers.\nPlatform Foundations\nYou'll also own the underlying systems that make all of this possible: data models, APIs, security, compliance, reliability, AI infrastructure, and production systems. We expect engineers to own products end-to-end, from the database schema all the way to the user experience.\nWho You Are\nYou've built in environments where mistakes matter. Whether in fintech, healthcare, insurance, logistics, or another operationally complex domain, you've worked on systems where data integrity, money movement, and business rules couldn't be treated as an afterthought.\n\nYou think in systems, not features. When someone describes a workflow, you naturally start modeling states, transitions, invariants, and edge cases. You enjoy turning messy real-world processes into clean software abstractions.\n\nYou have strong product instincts. You care about the user experience as much as the implementation. You can sit with a provider, understand their pain points, and translate them into software that feels simple despite complex underlying logic.\n\nYou thrive in ambiguity. You don't need a fully written PRD to get started. You're comfortable taking a loosely defined problem, identifying the important questions, proposing solutions, and driving execution.\n\nYou operate with high ownership. You don't think of your job as writing tickets. You think of your job as making a problem disappear. If something is blocking the business, you'll figure out how to solve it regardless of where it falls on the org chart.\n\nYou are AI-native. You actively use AI in your day-to-day workflow and are constantly experimenting with new ways to increase leverage. You're excited about what software development, operations, and healthcare workflows look like when AI is a first-class primitive rather than an add-on.\n\nYou balance speed with judgment. You know when to move fast and when to invest in foundations. You can build quickly without leaving behind a trail of technical debt that someone else has to clean up later.\n\nYou enjoy learning complicated domains. Healthcare is full of exceptions, regulations, payer rules, credentialing requirements, and operational edge cases. Rather than finding that frustrating, you find it intellectually interesting.\n\nYou still love writing code. You're experienced enough to lead major technical decisions, but you haven't lost the desire to build. You want to spend your time creating products and systems, not managing process.\n\nNice to Have\nExperience building AI-powered products in production\n\nExperience with LLM workflows, agents, evals, or developer tooling\n\nExperience modeling complex operational or financial systems\n\nHealthcare, EHR, insurance, or revenue cycle experience\n\nExperience at an early-stage startup where you owned large parts of the product\n\nWhy Join Now\nThe decisions made in the next year - how the domain model is structured, how state machines are enforced, how AI workflows are built safely - will define the system for a long time. You'd be joining after product-market fit but before the platform has fully caught up to the business. Not \"rescue a failing system.\" Build the foundation that lets a working, fast-growing system scale correctly.\nFounding engineer autonomy, real ownership, and a company that's clearly on its way somewhere.","description_format":"text","description_chars":6747,"description_truncated":false,"requirements":{"experience_years_min":null,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":[],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["Disability Support Services","Practice Management Software"],"lifecycle":[{"event":"open","at":"2026-09-10T17:36:35Z"}],"visa":[],"liveness":{"score":5,"band":"cold","label":"Long shot","p_open":1,"p_active":0.192,"p_room":0.28,"age_days":204,"expected_fill_days":26,"reasons":["conf:1","stale_co","ghost","win:tail","crowd:brand"],"computed_at":"2026-10-31T05:58:55Z"},"pay":{"stated_usd_annual":250000,"is_top_pay":true},"html_url":"https://alion.io/job/alpacahealth-senior-full-stack-software-engineer","json_url":"https://alion.io/job/alpacahealth-senior-full-stack-software-engineer.json","meta":{"generated_at":"2026-10-31T09:54:25Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":15055,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-01T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":668674},"rest":"https://alion.io/mcp/rest/get_company?id=668674"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Falpacahealth-senior-full-stack-software-engineer"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Falpacahealth-senior-full-stack-software-engineer"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Falpacahealth-senior-full-stack-software-engineer"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/alpacahealth-senior-full-stack-software-engineer\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Falpacahealth-senior-full-stack-software-engineer"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":599481}},{"tool":"search_jobs","arguments":{"company":"alpacahealth.io","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":599481},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. 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