United States onlyWe’re looking for a Senior Full-Stack Engineer who is deeply passionate about databases—specifically PostgreSQL—and excited to help refactor, optimize, and scale our data architecture. While strong backend skills in Node.js are highly desired, your ability to bring structure, performance, and insight to our data layer is what will set you apart.
Keep reading to learn more about the role, our team, and why this is an exciting opportunity for someone who thrives at the intersection of full-stack development and robust database design.
About the Role
As a Senior Full-Stack Engineer with a specialization in PostgreSQL, you will be the go-to person for improving and maintaining our database infrastructure. You’ll also support API development, data modeling, and backend services using Node.js, and—if you’re comfortable—contribute to our frontend stack as well. This role is perfect for someone who finds joy in writing elegant queries, improving schema design, and helping the team ship production-ready features faster using smart, scalable practices.
What You’ll Do
- Design, refactor, and optimize PostgreSQL database schemas, queries, and indexes to support scalable application growth
- Lead and contribute to backend development using Node.js and Typescript
- Collaborate with product and engineering teams to architect data flows and APIs that meet business needs
- Proactively identify performance bottlenecks and implement database best practices
- Use AI-powered tools to enhance productivity, improve code quality, and accelerate development workflows
- Optionally contribute to the frontend (React/Typescript) if you’re full-stack inclined
- Share your expertise by mentoring teammates in clean database architecture and backend engineering best practices
- 5+ years of experience as a full-stack or backend engineer
- Demonstrated mastery in PostgreSQL: schema design, optimization, migrations, complex query writing
- Strong backend development skills with Node.js and Typescript
- Experience designing, building, and scaling APIs
- Familiarity with using AI tools (e.g., Copilot, ChatGPT, Tabnine) in development workflows
- Strong attention to detail, with the ability to balance long-term architecture with immediate product needs
- Bonus: Experience with frontend frameworks (React) and a love for end-to-end ownership
- You’ll be solving meaningful problems that impact real users
- You’ll join a culture that respects deep expertise and encourages ownership
- You’ll work in a fast-paced, collaborative environment where ideas are welcome and growth is continuous
- You’ll be part of a team that values high standards, clear communication, and supportive mentorship
About the Product, Design, Engineering Team
At House Rx, we're driven by something special: making specialty medications more accessible and affordable. Our 25+ person product, design, and engineering (PDE) team, part of our broader 125+ person company, creates technology that helps patients access the life-saving drugs they need. We bring our hearts and minds to this meaningful work, fostering a caring, dedicated, and supportive environment.
Here's our amazing team that builds healthcare technology that matters:
- Software Engineering: 10 engineers+ from early career to staff/architect level
- Product & Design: 3 product managers, 1 designer
- Infrastructure: 2 IT specialists, 2 security engineers, 2 SREs
- Quality & Support: 3 QA engineers, 2 support specialists
Together, we build and maintain impactful solutions through our pharmacy management system and data insights platform. These tools enable our internal teams — pharmacists, care coordinators, and clinical operations — to streamline medication access, while helping external healthcare providers and clinics deliver better patient care.
Our engineering work presents exciting technical challenges as we balance user-facing features with robust internal systems. We release updates daily, requiring thoughtful prioritization and technical excellence while maintaining high quality. This iterative approach means we're constantly innovating to deliver meaningful improvements to our healthcare platform.
We're a fully remote team, with our talented people spread across New York, Boston, San Francisco, and throughout the U.S. While we embrace the flexibility of remote work, we're passionate about strengthening connections through our bi-annual retreats — both company-wide and PDE-specific — where we plan, grow, and celebrate our successes together. Local team members enjoy getting together for co-working and social events, creating bonds that go beyond the workplace.
Our culture brings thoughtfulness to our daily work. You'll find us expressing ourselves through our extensive Slack emoji and GIF collection (seriously, it's impressive!), sharing gratitude circles on birthdays, and having conversations that range from foodie recommendations to discussions about AI tooling, developer experience, and architecture. While we take our mission seriously, we believe enjoying what you do and technical excellence go hand in hand.
We're a fun, thoughtful, supportive, talented, and down-to-earth group focused on doing some of the best work of our lives. At the end of the day, we know software is built by people — and we're committed to taking care of both the people we work with and the patients whose lives we touch through our technology. We’re growing our team. There's no one else in the world like you, and hope you can join us for this ride!
Salary Range: $160,000 - $185,000This range represents the low and high end of the anticipated base salary/wage. The actual base salary/wage will depend on several factors, including experience, knowledge, and skills. Actual compensation packages may include other elements equity, paid time off and benefits.
Why You Should Join Our Team
A career at House Rx offers the chance to work with a talented group of entrepreneurs, healthcare professionals, and technology builders who are passionate about improving specialty care and making it easier for patients to access the medication that they need.
At House Rx, we strive to build and maintain an environment where employees from all backgrounds are valued, respected and have the opportunity to succeed. You'll find a culture that supports open communication, embracing failure as a learning opportunity, and always being open to new ideas—no matter how radical. We’re committed to creating a positive and collaborative culture to achieve our mission, all while supporting our team members in all aspects of their lives—at home, at work and everywhere in between.
In particular, we offer:
- Flexible work hours and flexible paid time off
- Work remotely
- Generous parental leave
- Comprehensive healthcare, vision and dental benefits
- Competitive salary and equity stake
- We’re backed by forward-thinking investors committed to transforming healthcare, including Bessemer Venture Partners, First Round Capital, LRV Health, Khosla Ventures, Maverick Ventures, 1984.vc, and Character
