Principal Engineer

Carease Health is a nationwide preventative healthcare company focused on reducing hospitalizations and improving outcomes for high-risk patients in skilled nursing facilities. We deliver Advanced Primary Care Management (APCM), Remote Patient Monitoring (RPM), and Collaborative Care (CoCM) services across hundreds of SNF and long-term care facilities. We are an established, privately held company operating at scale. Our mission is to keep patients healthier, safer, and supported outside the hospital setting by combining technology, clinical expertise, and proactive care coordination.

The Role

We are looking for a Principal Engineer to architect and build the proprietary clinical intelligence platform that will define Carease's next chapter. We have real clinical operations, real patient data across hundreds of facilities, established workflows, and an experienced clinical leadership team. What we haven't yet built is the platform itself. You are the person who builds it.

This is a hands-on role with full strategic ownership. In the first phase, you'll be architecting and building directly — writing code, making integration decisions, shipping early product. As the platform matures, you'll grow and lead the engineering team behind you, shifting toward delegation, hiring, and strategic oversight while keeping technical depth. You will report to the CEO and work closely with the broader leadership team.

What You Will Do

• Design and build the architecture of Carease's clinical intelligence platform end-to-end — data models, integration boundaries, AI layer, clinical decision support
• Own the EHR integration strategy across the leading SNF/LTPAC platforms
• Evaluate third-party clinical tools, assess their APIs, and build the integration layers
• Build AI capabilities across clinical decision support, documentation, and revenue integrity workflows — engineered for clinical defensibility
• Define FHIR, HL7, and internal API standards for interoperability across the platform
• Ensure HIPAA technical safeguards, AI governance, and CMS-defensible system design
• Own the product roadmap with concrete shipping milestones
• Hire and lead the engineering team as the platform scales

You have shipped clinical or healthcare systems in production — used by real providers, audited by real compliance teams. You can explain not just what you built but how you built it, at the architecture level. You have opinions about data models and integration patterns because you've lived with the consequences of getting them wrong. You're equally comfortable in the architecture seat and at the keyboard.

Specifically:

• 7+ years of software engineering with production systems you personally designed and built
• Production experience of healthcare data infrastructure and/or clinical AI
• Direct working knowledge of the SNF/LTPAC EHR ecosystem
• Fluency in healthcare data standards: FHIR, HL7, SNOMED, ICD-10, CPT
• Experience with cloud platforms (AWS / Azure / GCP), modern data architecture, and AI/ML systems in production
• Experience with multi-source data infrastructure at scale
• Working understanding of HIPAA, SOC 2, and HITRUST in real implementation contexts
• Experience building third-party integrations against vendor APIs
• Experience building production systems on top of existing, fragmented infrastructure
• Architectural decisions made fast, with conviction, owned end-to-end
• A track record of building hands-on early and scaling through delegation as the team grows

• Direct integration experience with leading SNF EHRs
• Background in clinical decision support, alerting systems, or predictive analytics for post-acute care
• Experience with APCM, RPM, CoCM, or related CMS chronic care programs
• Familiarity with FDA SaMD guidance and the CDS exclusion criteria

• Greenfield build on top of real data and real clinical operations — not a pitch deck
• Already revenue-generating and profitable — you're solving for real clinical action, not chasing a Series B
• High-ownership role with the autonomy to make architecture decisions that matter

On-site hybrid for the right candidate, with periodic presence in Lakewood, NJ for key inflection points. Base salary range: $220,000–$270,000, commensurate with experience. Comprehensive benefits package including medical, dental, and vision coverage, paid time off, and 401(k).

Equal Opportunity

Carease Health is an equal opportunity employer. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, age, disability, or veteran status.