Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents. Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it. We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community. Position title Principal Software Engineer Job SummaryWe're hiring a Principal Software Engineer to set the technical direction and own the architecture of our core systems. This is a hands-on senior leadership role. You'll design and evolve foundational systems (APIs, data flows, infrastructure patterns, reliability standards) while acting as a force multiplier for the engineering team. What You’ll Own - Platform-wide architecture across backend services and infrastructure - Technical scoping and design for cross-cutting initiatives (EHR integrations, multi-tenancy, scaling) - Reliability, scalability, and operational excellence - Developer experience and internal tooling - Engineering standards and best practices - High-impact system redesigns and architectural improvements - Engineering leverage through mentorship and code review 30/60/90-day plan Days 0 to 30 - Deep dive into platform architecture, codebase, and infrastructure - Audit scaling bottlenecks and reliability risks - Build strong working relationships with the engineering team and clinical stakeholders - Identify 2-3 high-leverage platform improvements - Ship at least one meaningful architectural fix Days 31-60 - Own the technical design for a major architectural initiative - Refine or establish platform-wide engineering standards - Improve observability and reliability patterns across services - Begin scoping and architecting work for other engineers to execute Days 61-90 - Recognized as the technical authority for your domain - Delivering on your first major initiative - Actively shaping the technical roadmap alongside product and leadership - Mentoring engineers and raising the bar on code quality and design rigor What We’re Looking For - 7+ years of professional software engineering experience, with principal-level impact in at least one prior role - Designed and operated large-scale distributed systems in production - Strong backend engineering background; comfortable working across the full stack - Excellent architectural judgment and ability to translate messy, real-world problems into clean technical designs - Experience working in healthcare, EHR integrations, or compliance-heavy environments is a significant plus - Comfortable owning systems end-to-end, from design through production operations Our stack Python (FastAPI), React/TypeScript, MSSQL, Redis, Azure (Container Apps, Static Web Apps, DevOps Pipelines), Terraform. Nice to have - Health tech experience or familiarity with EHR systems (eClinicalWorks, Ellkay, Redox, FHIR) - Experience with HIPAA-compliant systems and healthcare data - Experience scaling a multi-tenant SaaS platform - Experience building clinical rules engines or decision support systems - Public speaking or writing on technical topics Location Based in the Bronx, co-located with Essen Health Care. We sit next to the care coordinators, clinicians, and operators who use the platform every day and work in a community that we serve. Instead of scheduling a user research session, you can walk down the block and see someone using what you built. Hybrid 3 days on-site, 2 days remote. Why this role You’ll shape the technical foundation of a platform that’s live, growing, and directly improving healthcare for underserved communities. Essen Health Care and ecares health are Equal Opportunity Employers and are committed to creating an inclusive, diverse, and equitable workplace for all.