Principal Software Engineer

Overview

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents.

Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community.

Job Summary

Position title: Principal Software Engineer

Job Summary:We're hiring a Principal Software Engineer to set the technical direction and own the architecture of our core systems. This is a hands-on senior leadership role. You'll design and evolve foundational systems (APIs, data flows, infrastructure patterns, reliability standards) while acting as a force multiplier for the engineering team.

• Platform-wide architecture across backend services and infrastructure
• Technical scoping and design for cross-cutting initiatives (EHR integrations, multi-tenancy, scaling)
• Reliability, scalability, and operational excellence
• Developer experience and internal tooling
• Engineering standards and best practices
• High-impact system redesigns and architectural improvements
• Engineering leverage through mentorship and code review

30/60/90-day plan

• 7+ years of professional software engineering experience, with principal-level impact in at least one prior role
• Designed and operated large-scale distributed systems in production
• Strong backend engineering background; comfortable working across the full stack
• Excellent architectural judgment and ability to translate messy, real-world problems into clean technical designs
• Experience working in healthcare, EHR integrations, or compliance-heavy environments is a significant plus
• Comfortable owning systems end-to-end, from design through production operations

Our stack: Python (FastAPI), React/TypeScript, MSSQL, Redis, Azure (Container Apps, Static Web Apps, DevOps Pipelines), Terraform.

• Health tech experience or familiarity with EHR systems (eClinicalWorks, Ellkay, Redox, FHIR)
• Experience with HIPAA-compliant systems and healthcare data
• Experience scaling a multi-tenant SaaS platform
• Experience building clinical rules engines or decision support systems
• Public speaking or writing on technical topics

• Deep dive into platform architecture, codebase, and infrastructure
• Audit scaling bottlenecks and reliability risks
• Build strong working relationships with the engineering team and clinical stakeholders
• Identify 2-3 high-leverage platform improvements
• Ship at least one meaningful architectural fix

• Own the technical design for a major architectural initiative
• Refine or establish platform-wide engineering standards
• Improve observability and reliability patterns across services
• Begin scoping and architecting work for other engineers to execute

• Recognized as the technical authority for your domain
• Delivering on your first major initiative
• Actively shaping the technical roadmap alongside product and leadership
• Mentoring engineers and raising the bar on code quality and design rigor

Based in the Bronx, co-located with Essen Health Care. We sit next to the care coordinators, clinicians, and operators who use the platform every day and work in a community that we serve. Instead of scheduling a user research session, you can walk down the block and see someone using what you built.

Hybrid: 3 days on-site, 2 days remote.

Why this role

You’ll shape the technical foundation of a platform that’s live, growing, and directly improving healthcare for underserved communities.