Full Stack Software Engineer

About the role

📌 ABOUT ALPACA HEALTH

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care.

We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: use technology to make business ownership possible for every passionate provider.

We've raised over $14M in funding from early-stage investors like Core Innovation Capital, Adverb Ventures, and South Park Commons, and are building for long-term category leadership. More importantly, we're serving hundreds of patients, while growing 30% MoM.

This role is full-time. We’re looking for candidates based in New York City or San Francisco, excited about a 5 days in-office culture.

Both founders are technical. Every engineer on the team has experience at early-stage startups. Several have built products from zero to scale, and one previously founded a YC-backed company.

We care deeply about engineering quality, ownership, and building systems that correctly model reality. We do not have layers of management, architecture committees, or roadmap bureaucracy. Engineers talk directly to customers, make technical decisions, and ship.

🎯 ROLE: SENIOR SOFTWARE ENGINEER

We're a tiny engineering team building something large. You'd be the person who owns the platform foundation — the data models, the money logic, the state machines, the API contracts, the AI infrastructure. Not "owns" in the sense of reviewing PRs. Owns in the sense of: you designed it, you built it, you stand behind it.

One day you're designing a schema migration strategy. The next you're building an LLM pipeline for clinical documentation. The day after that you're debugging a billing edge case that only appears when Colorado Medicaid is the secondary payer.

This isn't a job for someone who wants to specialize. It's a job for someone who gets uncomfortable when critical business logic lives in someone's head instead of in code.

🚧 WHAT YOU’LL OWN

AI-NATIVE CLINICAL WORKFLOWS

We're rethinking healthcare software from the ground up with AI built into the core experience. You'll help build products that assist with clinical documentation, treatment planning, reassessments, supervision, and administrative work, giving providers more time to focus on patient care.

REVENUE & PAYMENTS INFRASTRUCTURE

Healthcare is ultimately a complex flow of money. You'll own systems that determine how services are authorized, billed, adjudicated, and paid, ensuring providers get paid accurately and on time while maintaining trust in the platform.

PROVIDER BUSINESS OPERATIONS

Starting a healthcare practice today is painfully manual. Build the tools that make credentialing, contracting, compliance, payroll, scheduling, and staffing feel effortless, allowing clinicians to focus on growing their practices instead of managing paperwork.