Senior Software Engineer, Virtual Care Platform

About Fabric Health At Fabric Health, we are powering boundless care by solving healthcare’s biggest challenge: clinical capacity. We aren’t here to disrupt healthcare; we’re here to fix it. We unify the care journey from intake to treatment, using intelligent automation to remove administrative burdens and make care delivery 2-10x more efficient. Our technology empowers clinicians to move faster and focus on what matters most: the patient. We are a mission-driven team of brilliant minds trusted by leading organizations including Intermountain Health, OSF HealthCare, SSM Health, and MUSC Health. Our vision is backed by premier investors such as Thrive Capital, GV (Google Ventures), General Catalyst, and Salesforce Ventures. We move quickly for good reason, listen deeply to solve big challenges, and build products with the same care and quality we’d want for our own loved ones. Learn more: About Us | News & Press | LinkedIn | Careers About the Role As a Senior Software Engineer on our Virtual Care Platform, you will be the strategic anchor of our platform's real-world reliability and patient experience. In this high-trust role, you hold the keys to production health; swiftly resolving critical issues while building the tools, automation, and features that make our platform stronger every day. You won't just be triaging tickets; you will own operational engineering. You'll work in Ruby on Rails to fix complex production bugs, perform precise live-data corrections, and directly protect patient care. Simultaneously, you'll spend significant time building new features for our internal admin portal, creating diagnostic tools, and engineering self-service capabilities that empower our Support and Implementation teams. If you thrive on direct impact, end-to-end autonomy, and building systems that scale, this role offers a high-visibility platform to showcase your problem-solving skills. What You'll Do As the Senior Software Engineer on the Virtual Care Platform, you own the bridge between Support and Engineering, protecting the core team's focus while keeping patients unblocked. Your primary responsibilities will include: Serving as the first line of engineering response for incoming production and support issues during business hours, triaging immediately and shielding the core product team from constant interruption. Prioritizing ruthlessly by patient impact, treating any issue that is preventing patients from receiving care as critical and jumping on it first. Diagnosing and fixing bugs across a large, mature Ruby on Rails codebase, from quick corrections to real root-cause changes. Making careful, safe live production data edits in Ruby to resolve urgent issues, with the discipline that patient-facing systems demand. Owning and improving the admin portal on the Virtual Care platform so Support and Implementations can work independently without relying on engineers. Building documentation, runbooks, and diagnostic tools that empower the broader Support team to resolve common issues on their own over time. Partnering closely with Support, Implementations, and Engineering to turn recurring incidents into permanent fixes rather than repeat fire drills. Tracking patterns across incoming issues and feeding them back into the product and platform so the same problems stop coming back. Why You Might Be a Good Fit You care deeply about the mission: You understand that a production bug here is not an inconvenience, it is a patient who cannot get seen, and you treat it that way. You are the person who runs toward the fire: You like being first on the urgent issue, triaging fast under pressure, and getting it fixed. You have real depth in Ruby on Rails: You are comfortable reading and editing a large, live Rails codebase and making safe production changes with confidence. You are a strong diagnostician: You move from symptom to root cause quickly and you fix the cause, not just the symptom. You take satisfaction in making yourself unnecessary: You document and build tooling so that Support can self-serve and the queue keeps shrinking. You are self-directed: You are comfortable being the solo owner of a domain, setting your own priorities against real urgency, and standing behind your calls. This Might Not Be The Right Fit If... You want to spend most of your time on greenfield roadmap feature work rather than triaging and resolving production issues. You are primarily a Node.js, TypeScript, or front-end engineer without deep, hands-on Ruby on Rails experience. You are not based in the United States; this role requires US-based work because of production console access and PHI. You are uncomfortable making careful live production data changes or participating in on-call coverage. You want a large team around you at all times; this is a solo role that bridges Support and Engineering. You prefer well-defined, stable systems over fast-moving, interrupt-driven work in a mature production environment. Your Qualifications 5+ years of professional software engineering experience, operating at a senior (IC3) level with a record of owning production systems end to end. Deep, hands-on Ruby on Rails expertise: you can navigate and edit a large, mature Rails codebase and make safe live production data changes. Strong debugging and production troubleshooting skills, with the composure to work incidents that are actively affecting patients. Based in the United States (hard requirement) due to production console access and handling of PHI. Experience operating production SaaS, ideally multi-tenant, with sound instincts for reliability and safe operational practices. Strong written communication for documentation, runbooks, and cross-functional collaboration with Support, Implementations, and Engineering. Comfort as a self-directed, solo owner who can set priorities against competing urgency and be trusted to make the right call. Bonus Points Experience building software in healthcare, or in another high-stakes, highly regulated, or safety-critical domain, especially with PHI in a HIPAA environment. Front-end experience with React (nice to have) and some familiarity with Angular, which the admin portal touches. A track record of building internal admin tools or self-service diagnostic tooling that reduced load on an engineering team. Prior experience in a production support, sustaining, or reliability-focused engineering role. Familiarity with healthcare interoperability standards such as HL7 or FHIR. The national pay range for this role is $140,000.00 - $170,000.00 per year. Actual compensation will be determined by factors such as the candidate's geographic market, experience, skills, and qualifications. Certain roles may also be eligible for additional compensation, including a comprehensive benefits package such as medical, dental, vision, unlimited PTO, and a 401(k) plan, stock options and bonuses. If your compensation requirement is greater than our posted range, please still consider applying; a determination can be made based on unique qualifications. Expected compensation ranges for this role may change over time.