Full Stack Ruby on Rails Software Engineer (Principal – Remote)

About This Opportunity

We are representing a confidential healthcare technology organization in their search for a Principal Full Stack Software Engineer specializing in Ruby on Rails. This is a fully remote position based in the USA.

Our client maintains a focused tech stack centered on Ruby on Rails, prioritizing shipping speed and developer experience over experimental technologies. Their platform serves critical healthcare workflows, and they're looking for a principal-level engineer who can drive technical direction while deepening the team's domain expertise in clinical operations.

The stack includes Rails on the backend, with Turbo, Tailwind, and ViewComponent powering the UI layer. Stimulus handles interactivity, with selective use of React where needed. Mobile applications leverage Hotwire Native to extend existing web infrastructure.

Responsibilities

• Lead technical collaboration on complex, cross-cutting systems including data modeling, API design, clinical workflow architecture, and integration patterns
• Scope and shape work end-to-end—from problem identification through implementation—working closely with product and design to define success criteria
• Write production code across the full stack (Ruby + Rails backend, Turbo/Tailwind frontend) with emphasis on systems and abstractions that enable other engineers
• Evaluate technical risk and tradeoffs, determining when to invest in architecture versus shipping the simplest viable solution
• Mentor and elevate team members through architecture discussions, pairing sessions, code review, and establishing high standards
• Develop deep domain knowledge in healthcare workflows and use it to challenge assumptions, surface risks early, and advocate for provider and patient experience
• Collaborate across engineering, product, design, and clinical/operations teams to align technical decisions with business and clinical objectives

What We're Looking For

Required qualifications:

• Significant professional software development experience, primarily with Ruby on Rails, with demonstrated ability to influence technical direction beyond individual contributions
• Strong systems thinking—you understand how features connect to broader architecture and can articulate tradeoffs to both technical and non-technical audiences
• Problem ownership mindset—you dig into the domain, question assumptions, and identify the right solution even when it's not obvious
• Thoughtful and empathetic approach to decision-making, execution, communication, and collaboration
• Track record of raising team standards through your work, feedback, and proactive improvement initiatives
• Comfort thriving in flat, self-managing teams where influence stems from clarity and trust rather than authority
• Developed workflow for building software with AI coding tools, with informed opinions about when they help versus hinder productivity
• Focus on solving problems rather than attachment to particular technologies or solutions
• Genuine interest in improving behavioral health outcomes for children, teens, and families

Bonus qualifications:

• Healthcare domain experience—clinical workflows, scheduling systems, EHR integrations, insurance billing, or multi-clinic operations
• Experience with complex data modeling and migration challenges
• API development and third-party system integration experience
• Familiarity with Shape Up or similar appetite-based development methodologies

How We Work With You

When you apply through Get A Job.ai, our talent team will conduct an initial screening to understand your background and technical experience. If there's a strong match, we'll submit your profile to our client for consideration. Please note that all applications must go through Get A Job.ai—candidates who contact the client directly cannot be considered for this role.

Our recruiting team will keep you informed throughout the process and serve as your advocate with the hiring organization.

Pay

The client has indicated a base salary range of $215,000-$240,000 annually for this position, plus equity, comprehensive benefits including medical/dental/vision, 401k, flexible spending account, 12 company holidays, PTO, parental leave, and various stipends (wellness, home office, cell/internet, professional development).

Equal Opportunity

Get A Job.ai is committed to inclusive recruiting practices. We welcome applications from candidates of all backgrounds and work to ensure equitable consideration throughout our process.