Principal Software Engineer

As Principal Software Engineer at Monogram Health, this role will be responsible for technical oversight for the design, build, and maintenance of applications and services that power clinical workflows and patient engagement, including APIs, background services, and web applications within the Azure ecosystem.

The Principal Engineer is the most senior individual contributor in the engineering organization, serving as the technical conscience and visionary for engineering at Monogram Health. They set the technical direction for the organization, drive innovation, and operate as a trusted advisor to executive leadership on technology strategy. Principal Engineers have outsized impact - shaping how the entire engineering team builds, operates, and evolves systems. They lead by influence, not authority, and are accountable for the long-term health of the technology platform.

Responsibilities

• Sets the technical vision and long-term architecture strategy for the engineering organization

• Serves as the highest individual contributor authority on technology decisions, platform direction, and engineering excellence

• Partners with executive leadership (VP, SVP, CTO) to align technology strategy with business objectives - bridging technical and business domains to drive decisions

• Drives organization-wide initiatives - platform modernization, build-vs-buy decisions, technical debt reduction, and innovation programs

• Evaluates emerging technologies and industry trends; determines applicability and leads adoption where valuable

• Coaches and develops Staff and Senior Engineers; raises the bar for technical leadership and hiring standards across the organization

• Establishes governance frameworks for architecture, security, data, and operational practices; represents engineering in vendor, partner, and industry evaluations

• Leads post-incident reviews and drives systemic improvements to reliability, security, and operational resilience

• Champions AI-assisted development practices across the engineering organization; evaluates tools, defines usage patterns, and drives adoption to improve velocity and quality at scale

• Participates in a shared on-call rotation to support production reliability and patient safety; on-call rotates across the team and volume is generally low

• Bachelor’s degree in Computer Science, Engineering, Information Technology, or a related field - or equivalent practical experience; Master’s or advanced degree strongly preferred

• Minimum of ten (10) years of professional engineering experience with significant time in senior technical leadership roles

• Proficiency in one or more backend languages/frameworks (e.g., .NET Core/C#, Node.js, Python, Java)

• Experience building and consuming RESTful APIs, microservices, and event-driven architectures

• Experience with Azure cloud services (App Services, Functions, Service Bus, Key Vault)

• Proficiency with relational databases (SQL Server, Azure SQL) and ORM frameworks

• Working knowledge of Git, Azure DevOps, CI/CD pipelines, and automated testing practices

• Expert-level proficiency across multiple domains - software, data, infrastructure, security, or platform engineering

• Proven track record of setting technical vision and strategy that drove measurable business outcomes

• Extensive experience leading cross-organizational technical initiatives and influencing without direct authority

• Demonstrated experience leveraging AI-assisted development tools and workflows to improve engineering velocity and quality

• Demonstrated communication skills - able to present to executives, influence peers, and mentor at all levels

• Advanced understanding of healthcare technology, compliance requirements (HIPAA, HITRUST, SOC2), and regulatory environments preferred

• Experience scaling engineering organizations and practices in high-growth or complex environments

• Familiarity with healthcare interoperability standards (HL7, FHIR) preferred

Pulled from the full job description Referral program Paid parental leave Parental leave Health insurance 401(k) matching Employee discount Vision insurance, * Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts

• Financial & Retirement Support - Competitive compensation, 401k with employer match, and financial wellness resources

• Time Off & Leave - Paid holidays, flexible vacation time/PSSL, and paid parental leave

• Wellness & Growth - Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders.

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.