{"id":670444,"url":"https://alion.io/job/flaglerhealth-senior-fullstack-engineer-rcm","title":"Senior Fullstack Engineer - RCM","company":{"id":673244,"name":"Flagler Health","domain":"flaglerhealth.io","url":"https://alion.io/company/flaglerhealth","size_band":"51-200","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Ashby","truth_index":{"grade":"B","score":83,"open_postings":3,"ghost_share":0,"stale_share":0.667,"repost_share":0,"time_to_fill_p50_days":44,"computed_at":"2026-10-30T05:48:23Z"}},"role":"Backend","role_family":"Backend","seniority":"senior","employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["New York, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":190000,"max":250000,"currency":"USD","period":"year","gross":null,"usd_annual":250000},"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"FHIR","optional":false},{"name":"HL7","optional":false},{"name":"Mongoose","optional":false},{"name":"React.js","optional":false},{"name":"TypeScript","optional":false},{"name":"Vue.js","optional":false},{"name":"AWS","optional":true},{"name":"AWS Step Functions","optional":true},{"name":"Azure","optional":true},{"name":"GCP","optional":true},{"name":"JavaScript","optional":true},{"name":"LLM","optional":true},{"name":"Node JS","optional":true},{"name":"OpenAI","optional":true},{"name":"Turborepo","optional":true}],"status":"live","first_seen_at":"2026-09-09T19:48:10Z","employer_posted_date":"2026-09-09","last_verified_at":"2026-10-30T12:50:04Z","board_verified":true,"closed_at":null,"days_open":50,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":50},"description":"Flagler Health is building the clinical operating system for modern musculoskeletal care.\nWe partner with MSK provider groups and specialty clinics to help them grow, operate more efficiently, and deliver better longitudinal care across patient acquisition, clinical workflows, and ongoing patient engagement. Our platform sits at the intersection of care delivery and clinic operations, helping providers capture more value across the full patient lifecycle.\nWe’ve recently raised our Series B and are entering our next phase of growth.\nSenior Fullstack Engineers own our main product surface end to end. One monorepo, one product: Vue 3 and TypeScript on the front, Express and MongoDB behind it, and a stack of shared TypeScript packages in between.\nYou will move across all of it rather than sit on one side.\nMost of the hard problems here aren't algorithmic. Clinical data is never clean, the same patient spelled three ways, a date that means something different in every system it passes through. And the people behind the data are people: they reschedule, they don't pick up, they tell the front desk what they never told their doctor. We're looking for engineers who find that interesting rather than annoying, and who'd rather model the mess than pretend it away.\nThe work is contract-first. API schemas are declared once and both frontend and backend typecheck against them, so a broken endpoint is a build failure instead of a bug report. If you've spent years keeping a hand-written client in sync with a backend that kept moving, this will feel like a relief.\nWhat You'll Do:\nBuild screens against our internal component library\n\nDesign and implement API routes contract-first, with schemas shared across frontend and backend\n\nModel clinical and revenue cycle data in MongoDB, and keep it queryable as collections grow\n\nWork inside shared TypeScript packages every app in the repo depends on\n\nTake features from spec to production and support them once they're live\n\nWork across the full revenue cycle, from pre-visit clearance through payment\n\nIntegrate with the EHRs and external systems that our clients already run on\n\nRequired Qualifications:\n5+ years building and shipping production web applications, including 3+ years of health care revenue cycle management experience\n\nStrong TypeScript across the stack\n\nHands-on experience with modern front-end framework such as Vue or React\n\nBackend experience with Node, Express, and MongoDB/Mongoose\n\nYou know what your queries cost. Patient, clinical, and financial data gets large and wide fast, and the difference between a query that scales and one that falls over is usually an index or a schema decision made months earlier\n\nYou can name the shortcomings of the tools you use, not just their features\n\nYou've designed for growth you couldn't fully predict, and can explain what you'd do differently now\n\nYou've worked in a large codebase you didn't write and improved it rather than rewriting it\n\nExperience moving health data between systems: HL7, FHIR, EHR connectivity\n\nYou've built complex yet auditable systems geared towards visibility\n\nExperience processing financial events while effectively managing states for each transaction\n\nYou’ve created configurable state machines and rule engines that can be easily tweaked to handle new cases with minimal code changes and long term maintenance\n\nPreferred Qualifications:\nUnderstanding of how care is delivered: clinical workflow, care pathways, how a patient moves through the system, and how a practice gets paid for it\n\nFamiliarity with the OpenAI API or similar LLM tooling\n\nMonorepo experience (e.g., Turborepo, Nx)\n\nRealtime or streaming applications\n\nDurable workflow orchestration (e.g., Temporal, Cadence, AWS Step Functions)\n\nExperience with cloud platforms such as AWS, Azure, or GCP\n\nExperience building analytics or reporting on top of transactional data\n\nExperience with EDI/X12 (270, 271, 835) is a plus\n\nWork Environment:\nDistributed remote team with hybrid offices in NYC and Vancouver.\n\nHybrid. Regular and consistent on-site presence is required for this position.\n\nOur Values:\nThis is what you can expect of your teammates at Flagler:\nOwner: We own our work like founders. We don't wait to be asked, and we pick up the problem nobody else has.\n\nBuilder: We like making things from scratch. We don't need a playbook to start, and we'd rather ship a rough first version than wait on a perfect spec.\n\nFast: We make quick decisions. We favor progress and respect process.\n\nTransparent: We communicate directly. We value merit and honesty, and we challenge assumptions, including our own.\n\nCurious: We explore new approaches and ask \"why\" often.","description_format":"text","description_chars":4681,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":[],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Medical AI","Care Coordination & Population Health"],"lifecycle":[{"event":"open","at":"2026-09-10T22:22:31Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 2","filings_12m":2,"filings_prev_12m":0,"green_card_filings_12m":0,"median_offered_wage_usd":207500,"route":null,"cap_exempt":false,"checked_at":"2026-10-29T16:27:21+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)"],"filings_for_role_12m":0}],"liveness":{"score":43,"band":"fade","label":"Fading","p_open":1,"p_active":0.776,"p_room":0.55,"age_days":50,"expected_fill_days":44,"reasons":["conf:1","win:tail"],"computed_at":"2026-10-30T05:48:23Z"},"pay":{"stated_usd_annual":250000,"is_top_pay":true},"html_url":"https://alion.io/job/flaglerhealth-senior-fullstack-engineer-rcm","json_url":"https://alion.io/job/flaglerhealth-senior-fullstack-engineer-rcm.json","meta":{"generated_at":"2026-10-30T17:08:09Z","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":5520,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-31T00:00:00Z"}},"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":673244},"rest":"https://alion.io/mcp/rest/get_company?id=673244"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fflaglerhealth-senior-fullstack-engineer-rcm"},{"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%2Fflaglerhealth-senior-fullstack-engineer-rcm"},{"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%2Fflaglerhealth-senior-fullstack-engineer-rcm"},{"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/flaglerhealth-senior-fullstack-engineer-rcm\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fflaglerhealth-senior-fullstack-engineer-rcm"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":670444}},{"tool":"search_jobs","arguments":{"company":"flaglerhealth.io","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":670444},"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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