Senior Software Engineer, Full Stack

Senior Software Engineer, Full Stack

Location: New York City (Hybrid, 3 days in office per week)

Reports to: CTO

Kinstead is building the AI-native operating system for independent healthcare, enabling nurse practitioners to launch and run their own clinics. We replace the fragmented, manual infrastructure behind healthcare with a single, intelligent system so clinicians can spend their time on care, not paperwork.

This creates a new model of care, one where clinicians practice on their terms and patients get consistent, community-rooted care. We're backed by Wisdom Ventures and leaders from PathAI, Pomelo Care, and Flatiron Health on our mission to deliver better care.

About the Role

We're hiring a senior software engineer to build and own core product functionality across the stack.

You'll design and implement the systems that power reliable clinical and operational workflows, from backend services and APIs to the frontend experiences that clinicians use every day. You'll work on everything from application logic and asynchronous processing to user-facing features, collaborating closely with the rest of the engineering team to ship complete product capabilities.

We care deeply about reliability, correctness, and building software that behaves predictably under real-world conditions. Many of our most interesting engineering problems involve workflow design, state management, integrations, and ensuring complex systems remain understandable as they grow.

You do not need prior healthcare or FHIR experience. We care more about strong engineering fundamentals, sound technical judgment, and the ability to ramp quickly on a complex domain.

You'll work closely with the CTO on system design while maintaining ownership of implementation, production quality, and the long-term health of the systems you build.

How We Work

We use AI coding tools such as Claude Code, GitHub Copilot, and Codex every day. We expect every engineer to be comfortable incorporating AI into their development workflow. AI accelerates implementation, but engineers remain responsible for system design, debugging, code review, and everything that reaches production.

What You'll Do

• Build and own product features across the stack using Python, Django, React, and Next.js
• Design and implement the systems behind clinical and operational workflows, including scheduling, messaging, and practice operations
• Build APIs, application logic, and integrations with clinical and third-party systems
• Collaborate with engineers, designers, and clinical stakeholders to turn complex workflows into intuitive software
• Debug and resolve production issues across the frontend, backend, and infrastructure
• Design systems that remain reliable, maintainable, and predictable as the product grows
• Contribute to system design, technical planning, architecture discussions, and code reviews

Our Stack

Python (Django, async-first with django-ninja and Channels), Next.js, PostgreSQL (with pgvector), Redis, WebSockets, asynchronous background jobs, workflow state machines, and clinical integrations using Medplum and FHIR.

Our services run on AWS and Kubernetes, and we rely on Terraform for IaC and Datadog for APM and infrastructure monitoring.

We maintain automated testing and deployment pipelines using Github Actions and integrate with AI providers including Google (Vertex AI), Anthropic (AWS Bedrock), and OpenAI.

What Success Looks Like

• You independently scope, build, and ship production features across the stack
• Clinical and operational workflows feel intuitive to users while remaining reliable in production
• The systems you build remain understandable, maintainable, and easy to extend as the product grows
• You make sound engineering decisions that balance product velocity with long-term quality
• You understand how frontend behavior, backend services, and infrastructure work together as a complete system
• You use AI development tools effectively while maintaining strong ownership of the code and systems you build
• You can investigate and resolve production issues across the stack without waiting for someone else

Requirements

• 5+ years building production web applications
• Strong backend engineering experience with a modern server-side language or framework (Python, Go, Kotlin, TypeScript, Java, C#, or similar)
• Comfortable building product features across the stack, including React/Next.js
• Strong engineering judgment and debugging skills
• Comfortable owning features from design through production
• Comfortable using AI development tools while maintaining ownership of the systems you build
• Ability to commute to Kinstead's Columbus Circle office 3x week

Nice to Have

• Experience building workflow-driven or stateful systems
• Experience with React and Next.js
• Experience with Kubernetes or distributed systems
• Experience with healthcare, FHIR, or other regulated software
• Experience working at an early-stage startup

Benefits

• Competitive salary and generous, early-stage equity (4-year grant)
• Health, vision, and dental benefits
• 401(k)
• Unlimited PTO
• Prime office in Columbus Circle with weekly team lunches
• Fun team events and offsites

At Kinstead, we're building infrastructure for healthcare that serves entire communities—not just a narrow slice of them. That requires a team with diverse perspectives, lived experiences, and ways of thinking. We are committed to hiring people from a wide range of backgrounds, including but not limited to race, ethnicity, gender identity and expression, sexual orientation, age, national origin, religion, disability, and veteran status. We believe better teams build better systems—and better systems lead to better care.

We aim to pay competitively for our stage and the importance of the work. Compensation includes base salary, meaningful equity, and benefits, and is designed to align long-term incentives with the impact you'll have at Kinstead. In accordance with applicable laws, we provide a reasonable estimate of the salary range for this role. Final compensation will depend on a number of factors, including experience, skillset, and leveling, as well as internal equity considerations. For this role, the estimated base salary range is $160,000 – $205,000.