Staff Backend Software Engineer (Elixir)
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Requirements
• Product mindset - You think like a founder, balancing technical excellence with business outcomes, revenue, and patient impact. You see gaps as opportunities and help define what we build, not just how. • Product mindset • Strategic technical leadership - You lead large, complex projects with clear business impact. You influence senior leaders on engineering strategy and make compelling recommendations on build vs. buy decisions, strategic technical investments, and any relevant engineering decisions. • Strategic technical leadership • Deep backend expertise - Expert-level proficiency in Elixir with deep knowledge of distributed systems, API design, and building scalable architectures that solve problems long-term. • Deep backend expertise • System design and reliability - You build resilient, well-tested systems with proper monitoring, rollout practices, and production stability for healthcare-critical workloads. • System design and reliability • High autonomy and ownership - You thrive in ambiguous environments, educate non-technical stakeholders, and own outcomes without needing detailed requirements or constant direction. • High autonomy and ownership • Startup adaptability - You're highly communicative across operational and clinical teams, move fast when needed, and understand when to ship quickly versus architect for scale. • Startup adaptability • Continuous improvement mindset - You proactively identify areas for improvement in systems and processes without being asked, and drive initiatives to address them. • Continuous improvement mindset • 10+ years of software development experience • Expert-level proficiency in Elixir • Experience building and shipping high quality work and achieving high reliability • Experience improving quality through thoughtful code reviews, appropriate testing, proper rollout, and monitoring • Passionate about improving healthcare access and outcomes • Experience with healthcare technology including data standards (FHIR, HL7, X12), EHR/vendor integrations, HIPAA-compliant systems for protected health information, and healthcare-specific APIs (clearinghouses, billing platforms) • Experience with Phoenix LiveView • Location • Must be US-based with openness to travel for in-person collaboration • Strong preference for candidates in the San Francisco Bay Area who can work in-person 2-3 days per week
Responsibilities
• Build the technical foundation for virtual care delivery. You'll design and implement the core platform that connects our EHR, care management systems, billing infrastructure, and patient communication tools. This means creating robust integrations, establishing data flows, and ensuring HIPAA-compliant architecture that can scale as we grow to thousands of patients. • Build the technical foundation for virtual care delivery. • Enable operational intelligence and automation. You'll build the data infrastructure and tooling that allows our clinical team to make informed decisions, automate care workflows, and track patient outcomes in real-time. This includes everything from patient dashboards to automated patient outreach triggers to clinical decision support. • Enable operational intelligence and automation. • Lead critical technical decisions. You'll evaluate build vs. buy trade-offs, recommend technology choices, and architect solutions that balance immediate needs with long-term scalability. You'll partner with the GM and Papa's engineering leadership to shape our technical roadmap and determine when to leverage vendor tools versus building custom solutions. • Lead critical technical decisions. • Establish engineering practices. As the first engineer, you'll define code standards, testing expectations, deployment processes, and technical documentation practices, leveraging best practices from the Papa core engineering team. • Establish engineering practices. • Own system reliability and performance. You'll be responsible for production stability, monitoring, and continuous improvement of our platform. This means building resilient systems for healthcare-critical workflows where reliability isn't optional - claim submissions, patient data accuracy, and care coordination all need to work consistently. • Own system reliability and performance.
Benefits
• Competitive salary & equity • Medical, dental and vision insurance coverage • Health Savings Account (HSA) & Flexible Spending Account (FSA) • 401(k) plan with a match up to 4% • Flexible PTO & 11 company holidays • Parental leave and caregiver leave • Actual compensation will be determined based on a variety of factors, including but not limited to candidate experience, location, education, certifications, and skill set. In addition to base salary, our total compensation package includes equity, comprehensive health benefits (medical, dental, vision), generous paid time off, and additional wellness and professional development perks.Not sure if you meet every requirement? Research shows that women and people from historically underrepresented communities often hesitate to apply for roles unless they meet every qualification compared to other similarly-qualified candidates. At Papa Community, we are committed to fostering a workplace where everyone feels valued, empowered, and supported. If this role excites you, we encourage you to apply. • Papa’s culture is people first. While we have an incredible team of hard-working Papa people, at the end of the day, our company is really about community – and we celebrate that among our employees. We encourage everyone to bring their whole authentic selves to work. To be transparent. To be non-hierarchical. And, above all, to be a really good person. • We see ourselves as a place where every Papa employee feels they belong, a place where careers flourish, a place that brings back purpose and joy to work, a culture where visionaries/entrepreneurs are developed.