[Hiring] Staff Software Engineer @Carrum Health

Role Description

As a Staff Software Engineer on our billing and payments platform, you will set the technical direction for the systems that price, bill, and pay for every episode of care that runs through Carrum. Your responsibilities include:

• Bundled pricing and contracts
• Invoicing and provider payments
• The financial data our Finance and Operations teams rely on

Your first big job is to centralize pricing into a single pricing service, define clear service boundaries and data models for billing, and lay a foundation that supports new service lines without a rewrite. You will work primarily in Ruby on Rails in a Service-Oriented Architecture, with React on the front end and PostgreSQL underneath. You will partner with Product, Finance, Operations, and Data.

You’re excited about this opportunity because you will:

• Own the technical vision for billing and payments, and turn it into a plan that ships in increments instead of a big-bang rewrite.
• Lead the work to centralize pricing into a single source of truth and decouple billing from the systems it is tangled up with today.
• Own revenue-critical systems end to end. Make them correct, observable, and safe to change, and catch problems before Finance or our clients do.
• Partner with Product and Finance to shape the roadmap, question requirements early, and explain engineering tradeoffs in business terms.
• Lead technical initiatives that span more than one team, without needing positional authority to get them done.
• Write the design docs, ADRs, and diagrams that become the reference for how billing works at Carrum.
• Grow the engineers around you through design reviews, code reviews, and mentoring that improves decisions, not just code.
• Help set how we use AI in a domain where correctness matters. Apply it where it creates leverage, and put guardrails where it does not.

Qualifications

• 8+ years building and running production systems, with a focus on outcomes driven.
• Experience leading technical initiatives across multiple teams in ambiguous problem spaces.
• Designed APIs and data models that serve multiple consumers, with knowledge of evolving them without breaking dependencies.
• Production experience in core technologies: Ruby on Rails, React, PostgreSQL, Docker, and a major cloud platform (AWS).
• Understanding of financial correctness, auditability, monitoring, and safe rollback as core requirements.
• Ability to explain complex systems to non-technical stakeholders and build trust through follow-through.
• Daily use of AI tools for design, build, debug, and documentation.
• Entrepreneurial and resourceful mindset, capable of finding creative solutions quickly.

Requirements

• Experience with billing, invoicing, payments, or other financial systems.
• Healthcare payments experience: bundled or value-based pricing, claims, or provider reimbursement.

Benefits

• Stock option plan and performance bonus for eligible employees.
• Flexible schedules and remote work.
• Chicago and San Francisco offices available as an option.
• Flexible PTO, within reason.
• Summer Fridays (sign off @ 1pm local time).
• 15+ paid holidays, including Juneteenth, World Mental Health Day, and Carrum Health Day.
• Annual holiday shutdown in December.
• Paid parental leave.
• Health, vision, and dental insurance.
• Employee Assistance Programs (EAP).
• 401K retirement plan.