Staff Fullstack Engineer

About Alaffia & Our Mission Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the healthcare ecosystem, driving up costs for plans, providers, and patients alike. We’re here to change that paradigm. Alaffia is a new kind of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently better outcomes across the entire lifecycle of claims. With Alaffia, health plans can cut wasted spending more effectively than ever, and provide their members the most affordable care. We’re a high-growth, venture-backed Series B healthtech startup based in NYC and are actively scaling our company. Join us in helping to build a healthcare system that works better for everyone. About the Role We’re looking for a Staff Fullstack Engineer to solve complex, cross-team technical challenges, set architectural direction across the stack, and act as a force multiplier across our engineering org. You’ll translate strategic goals into technical roadmaps, lead execution, and champion AI-augmented development practices. You’ll help scale our GenAI applications and shape the interfaces our Payment Integrity and Operations teams rely on every day. That means building React-based applications at the center of our platform, backed by strong backend architecture, system design, and cloud infrastructure, and turning complex workflows into fast, intuitive experiences. Note on language: this role will work across React and TypeScript on the frontend, and Python or TypeScript on the backend, depending on team need. You don’t need deep experience in every part of the stack. What matters most is strong, transferable engineering fundamentals and the ability to pick up new languages and tooling as needed. We’ll find the right fit for your background on our team. What You’ll Do

• Architect and own delivery of complex, high-impact systems spanning frontend and backend, across multiple teams
• Set technical direction and coding and design standards for the org, including frontend architecture, state management, component design, and performance
• Design, build, and maintain production-grade React applications that power our core auditing and workflow tools
• Design, develop, and deploy data-intensive applications in a production environment
• Partner with backend, product, and design to define clean API contracts and ensure smooth end-to-end integration
• Improve frontend and backend infrastructure, including build tooling, testing practices, and CI/CD pipelines
• Drive AI coding tool adoption (Claude Code), establish best practices, and measure productivity gains
• Mentor senior engineers and influence technical decisions without formal authority
• Partner cross-functionally with data, DevOps, and AI engineers, as well as product and business teams, to craft a feature-rich, GenAI-powered claim review platform
• Improve UI performance, accessibility, and overall user experience across the platform
• Own testing strategy, system health, observability, and build-vs-buy decisions for critical infrastructure
• Debug and resolve complex, cross-component issues across the stack

What We’re Looking For

• 10+ years of software engineering experience, with a track record of leading complex, high-impact projects at scale, including production-level API development and backend data processing
• Deep hands-on expertise in React, with a strong command of modern JavaScript and TypeScript, component architecture, and state management patterns
• Hands-on experience with relational databases and data model design
• Strong system design and cloud infrastructure experience (AWS preferred), including CI/CD, containerization (Docker, Kubernetes), and observability practices such as logging, user activity metrics, and integration with Datadog or similar tooling
• Experience building and scaling systems within a growing engineering team
• Track record of collaborating cross-functionally with backend, product, and design to ship high-quality features, with a strong eye for UX
• Comfortable working through ambiguity and translating operational or business requirements into clean technical solutions
• Experience with testing frameworks and CI/CD tooling for both frontend and backend applications
• Demonstrated success adopting AI coding assistants to improve team productivity
• Excellent communication skills and experience mentoring senior engineers

Preferred

• Experience building B2B SaaS products, particularly for operations, clinical, or financial teams, and in healthcare technology or another highly regulated industry
• Experience shipping user-facing AI products or AI/ML model deployment, including chat interfaces, agentic workflows, or natural language interactions
• Familiarity with design systems and building reusable, scalable component libraries
• Experience optimizing performance for data-dense, workflow-heavy applications
• Building SDKs or libraries
• Experience with vector databases
• Experience with data processing orchestrators, such as Airflow or Dagster
• Experience with message queue systems, such as AWS SQS, Kinesis, or Kafka
• GraphQL and PostgreSQL experience
• Open source contributions or technical publications

Our Culture Alaffia was born out of our founders’ personal connection to the inefficiency of the U.S. healthcare system. We are deeply mission-driven, with an abiding belief that technology can help create a better future for everyone, and we’re looking for others who share our passion for change to join the team. What Else Do You Get?

• Competitive compensation package (cash + equity)
• Medical, Dental, and Vision benefits
• Flexible, paid vacation policy
• Work in a flat organizational structure, with direct access to Leadership

About Alaffia & Our Mission Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the healthcare ecosystem, driving up costs for plans, providers, and patients alike. We’re here to change that paradigm. Alaffia is a new kind of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently better outcomes across the entire lifecycle of claims. With Alaffia, health plans can cut wasted spending more effectively than ever, and provide their members the most affordable care. We’re a high-growth, venture-backed Series B healthtech startup based in NYC and are actively scaling our company. Join us in helping to build a healthcare system that works better for everyone. About the Role We’re looking for a Staff Fullstack Engineer to solve complex, cross-team technical challenges, set architectural direction across the stack, and act as a force multiplier across our engineering org. You’ll translate strategic goals into technical roadmaps, lead execution, and champion AI-augmented development practices. You’ll help scale our GenAI applications and shape the interfaces our Payment Integrity and Operations teams rely on every day. That means building React-based applications at the center of our platform, backed by strong backend architecture, system design, and cloud infrastructure, and turning complex workflows into fast, intuitive experiences. Note on language: this role will work across React and TypeScript on the frontend, and Python or TypeScript on the backend, depending on team need. You don’t need deep experience in every part of the stack. What matters most is strong, transferable engineering fundamentals and the ability to pick up new languages and tooling as needed. We’ll find the right fit for your background on our team. What You’ll Do

• Architect and own delivery of complex, high-impact systems spanning frontend and backend, across multiple teams
• Set technical direction and coding and design standards for the org, including frontend architecture, state management, component design, and performance
• Design, build, and maintain production-grade React applications that power our core auditing and workflow tools
• Design, develop, and deploy data-intensive applications in a production environment
• Partner with backend, product, and design to define clean API contracts and ensure smooth end-to-end integration
• Improve frontend and backend infrastructure, including build tooling, testing practices, and CI/CD pipelines
• Drive AI coding tool adoption (Claude Code), establish best practices, and measure productivity gains
• Mentor senior engineers and influence technical decisions without formal authority
• Partner cross-functionally with data, DevOps, and AI engineers, as well as product and business teams, to craft a feature-rich, GenAI-powered claim review platform
• Improve UI performance, accessibility, and overall user experience across the platform
• Own testing strategy, system health, observability, and build-vs-buy decisions for critical infrastructure
• Debug and resolve complex, cross-component issues across the stack

What We’re Looking For

• 10+ years of software engineering experience, with a track record of leading complex, high-impact projects at scale, including production-level API development and backend data processing
• Deep hands-on expertise in React, with a strong command of modern JavaScript and TypeScript, component architecture, and state management patterns
• Hands-on experience with relational databases and data model design
• Strong system design and cloud infrastructure experience (AWS preferred), including CI/CD, containerization (Docker, Kubernetes), and observability practices such as logging, user activity metrics, and integration with Datadog or similar tooling
• Experience building and scaling systems within a growing engineering team
• Track record of collaborating cross-functionally with backend, product, and design to ship high-quality features, with a strong eye for UX
• Comfortable working through ambiguity and translating operational or business requirements into clean technical solutions
• Experience with testing frameworks and CI/CD tooling for both frontend and backend applications
• Demonstrated success adopting AI coding assistants to improve team productivity
• Excellent communication skills and experience mentoring senior engineers

Preferred

• Experience building B2B SaaS products, particularly for operations, clinical, or financial teams, and in healthcare technology or another highly regulated industry
• Experience shipping user-facing AI products or AI/ML model deployment, including chat interfaces, agentic workflows, or natural language interactions
• Familiarity with design systems and building reusable, scalable component libraries
• Experience optimizing performance for data-dense, workflow-heavy applications
• Building SDKs or libraries
• Experience with vector databases
• Experience with data processing orchestrators, such as Airflow or Dagster
• Experience with message queue systems, such as AWS SQS, Kinesis, or Kafka
• GraphQL and PostgreSQL experience
• Open source contributions or technical publications

Our Culture Alaffia was born out of our founders’ personal connection to the inefficiency of the U.S. healthcare system. We are deeply mission-driven, with an abiding belief that technology can help create a better future for everyone, and we’re looking for others who share our passion for change to join the team. What Else Do You Get?

• Competitive compensation package (cash + equity)
• Medical, Dental, and Vision benefits
• Flexible, paid vacation policy
• Work in a flat organizational structure, with direct access to Leadership