Join us to Improve Health Equity for 5 Million People!
CareMessage is the technology non-profit building the largest patient engagement platform for low-income populations in the United States. Powered by the Health Equity Engine™, the platform enables organizations to combine messaging, data, and interoperability to increase access to care, improve clinical outcomes, and address social drivers of health.
With 20 million patients reached since 2013, CareMessage is the only patient engagement solution proven to improve health equity at scale. The team, many with lived experiences in these communities, leverages a nonprofit model to reinvest revenue into impact. CareMessage is the partner of choice for organizations committed to advancing health equity.
Who We're Looking For
We are looking to hire a Senior Software Engineer I, (L3) for the Messaging Team who will own and drive the technical direction of CareMessage's messaging platform which is one of the core systems powering patient communication for over 400 safety-net healthcare organizations in the United States. You will independently own complex features end-to-end, mentor other engineers on the team, and contribute to architectural decisions that shape how we build and scale our messaging infrastructure.
This is a highly cross-functional role with shared team lead responsibilities. You'll work closely with Product, Customer Success, and Engineering to design and deliver messaging features that deepen patient engagement and health outcomes, with direct ownership of technical decisions and customer-facing system behavior. You will report to the Director of Engineering and play a key role in advancing our messaging capabilities as we scale.
Who You Are
You are a seasoned backend engineer who thrives in dynamic, fully distributed environments. You bring deep experience with Ruby on Rails and messaging systems at scale, and take pride in building reliable, patient-centric communication infrastructure. You are energized by the challenge of delivery optimization, consent management, and AI-driven messaging and you have the technical leadership to guide and mentor your teammates.
You take a scientific approach to everything you do. You rely on evidence, not intuition, and you look for data that challenges your assumptions before drawing conclusions. You contribute to PRDs, documentation, and wikis with this same mindset, using data to guide decisions and validate your work. You're excited about operating in a mission-driven, fast-moving environment and bring the experience and ownership mentality to lead from the front. Most importantly, you share our commitment to advancing health equity for low-income populations and take pride in contributing to that mission through the systems you build.
Core Requirements
Minimum 5 years of hands-on software engineering experience, with strong proficiency in Ruby on Rails and JavaScript.Minimum 5 years experience building, maintaining, and scaling backend systems, APIs, and services, with demonstrated experience owning complex features end-to-endSolid fundamentals of computer programming, including a good understanding of software development lifecycle, coding best practices, design patterns, object-oriented architecture, etc.Advanced SQL proficiency with a strong analytical mindset, comfortable querying and working with large, complex datasets to uncover insights, troubleshoot issues, and inform technical decisionsA commitment to supporting and fostering diversity and inclusion (We have a global team and you will regularly collaborate with people from a variety of walks of life.)Demonstrated ability to independently own and deliver complex projects end-to-end, break down large features into manageable tasks, mentor junior engineers, and influence technical direction within a teamGrowth-oriented mindsetOutstanding written and verbal communication skills, especially in a fully remote environmentExcellent ability to collaborate with technical and non-technical partners to support discovery, development, and testing phases of messaging platform featuresExperience working in teams where automated tests are an expected part of development, including writing and maintaining tests alongside production codeProven ability to work autonomously, proactively identifying challenges before they escalate, driving solutions independently, and maintaining clear, consistent communication with stakeholders to keep projects moving forward.
Preferred Experience
Experience with Twilio (SMS, Voice, or Messaging APIs) or similar messaging/communications platformsExperience with RCS (Rich Communication Services) or multimedia messaging (MMS)Experience with our tech stack: Ruby on Rails, JavaScript (React), PostgreSQL, Google Cloud Platform, background job processing (Sidekiq or similar)Experience with message queue systems, event-driven architecture, or high-throughput delivery pipelinesExperience in healthcare technology or familiarity with messaging compliance requirements, including TCPA, opt-out management, consent workflows, A2P 10DLC, and The Campaign Registry (TCR)
Role Responsibilities
You will own and drive the technical direction of key messaging platform features, collaborating with Product, Customer Success, Data, and Engineering to design and deliver solutions that deepen patient engagement and health outcomesYou will design, build, and maintain backend messaging systems using Ruby on Rails, including SMS/voice delivery pipelines, consent management workflows, message scheduling and orchestration, and Twilio integration layersYou will share team lead responsibilities with peers, including mentoring L2 engineers, leading technical design discussions, conducting code reviews, and helping set technical direction for the Messaging teamYou will contribute to architectural decisions that shape how we build and scale our messaging infrastructure, including delivery optimization, AI-driven message categorization, and multimedia messaging (MMS/RCS)You will provide technical training and documentation for messaging systems you build and maintain, enabling support teams to monitor, troubleshoot, and measure the impact of messaging features in productionYou will work closely with Product teams to understand requirements and lead technical input during solution definition, including ownership of technical scoping and active participation in Product Requirements Documents (PRDs)You will help improve the team over time through essential team rituals, such as Kickoffs, Retrospectives, and Technical Debt ReviewsYou will contribute to the team by participating in On-Call (PagerDuty) activities
Within 1 month you will:
Have a working familiarity with CareMessage's messaging platform, features, and APIUnderstand our messaging infrastructure, Twilio integration, and Software Development LifecycleLearn and follow CareMessage's engineering standards, coding best practices, and development processesEstablish rapport with engineers on the team through Wiki contributions, 1:1 conversations, and Team RitualsBegin reviewing PRs and participating in technical design discussions
Within 3 months you will:
Be independently owning and delivering complex messaging features end-to-end with meaningful impactHave a strong understanding of our messaging architecture and have identified areas for improvement in our processes, systems, and toolingUnderstand our Company Objectives and Key Results and be able to articulate how the Messaging team directly impacts themBe actively mentoring L2 engineers through code reviews, pair programming, and technical guidanceHave begun contributing to technical design decisions and architectural discussions
Within 6 months you will:
Be recognized as a technical leader on the Messaging team, having developed strong trust and rapport with peers and cross-functional partnersHave full ownership of major messaging platform features from design through production support, driving projects that directly impact patient outcomesShare team lead responsibilities with peers, including leading technical design sessions, setting engineering standards, and guiding the team's technical roadmapContribute your expertise in one or more strategic areas that drive value across the engineering department (e.g., delivery optimization, AI-driven messaging, MMS/RCS capabilities, consent management architecture)
