Senior Fullstack Engineer

Senior Fullstack Engineer

San Francisco, CA (5 days/week onsite)

Salary Band: $230,000 - $280,000 (Open to Staff leveling at $280-330K)

At Mochi, our engineering team operates with exceptional leverage. We believe in high talent density, where a focused, pragmatic team powers a profitable, nine-figure ARR healthcare platform serving hundreds of thousands of patients. We are looking for an Engineering Manager to help us scale, align, and unblock this organization.

Mochi has already helped patients lose over 5 million pounds through metabolic care, and we are now rapidly expanding into the frontiers of preventative healthcare. To support this growth, we are actively leveling up our engineering maturity—pairing our ambitious, early-career engineers with incoming Senior and Staff-level talent to build our next generation of clinical systems.

At Mochi, engineering is deeply integrated with our clinical and operational teams. We do not operate in silos. We need an Engineering Manager who is a true collaborative partner: someone who excels at mentoring junior developers, recruiting senior talent, maintaining a culture of high technical craft, and working directly with clinical leadership to co-design solutions for massive healthcare challenges. If you are a deeply technical leader who meets engineers where they are and cares profoundly about patient outcomes, this is the role.

What You'll Do

• Build High-Density Healthcare Interfaces: You will build the complex tools our clinical team relies on to treat patients safely. You will architect dynamic, multi-step medical intake engines, high-density provider charting dashboards, and patient-facing apps that handle sensitive PHI with perfect state synchronization.
• Bridge Clinical & Client: Connect our complex backend medication ordering and fulfillment pipelines to intuitive, highly responsive frontend interfaces. You will translate dense healthcare requirements into seamless digital experiences.
• Champion the User Experience: You don't just implement specifications; you deeply care about how patients and providers experience Mochi. You sweat the details of the UI and possess the strong product sense required to make pragmatic, high-quality design decisions on the fly that measurably improve patient outcomes.
• Own the Full Lifecycle: True full-stack means owning the delivery. You will design the database schema, write the API, build the React interface, deploy the service, and own both backend reliability and client-side error tracking in production.
• Build Agentic Workflows: Mochi is an AI-first engineering org. You will not only utilize frontier agentic models to accelerate your own development, but you will also integrate AI capabilities directly into our product to automate clinical operations and scale our provider workflows.
• Raise the Engineering Bar: Own key architectural decisions across the stack, systematically upgrade legacy code, and elevate the engineers around you through rigorous code review, testing practices, and technical standards.

Who You Are

• You have operated high-stakes systems. You have 5-7+ years of full-stack engineering experience. You've built and operated production systems that handle real complexity, crossing the boundary between complex backend domain logic and polished frontend user experiences.
• You master client-side state and performance. You know how to manage complex state across a large frontend application. You understand the tradeoffs of server-side rendering vs. client-side fetching, caching strategies, and how to build interfaces that feel instantaneous even when the underlying healthcare APIs are slow.
• You get data modeling right. You think carefully about schema design and API boundaries, because you've seen what happens to the frontend when the foundational backend model is wrong.
• You are a full lifecycle owner. You build things that run in production, not just pass review. You are comfortable with (or eager to master) Kubernetes, Terraform, AWS, and CI/CD, and you view deploying your own code and owning your system's reliability as a fundamental part of your job.
• Your workflows are altered by AI. You are already using frontier agentic tools (e.g., Codex 5.3, Claude Opus 4.6) to build faster. You can describe specific ways these models have structurally changed how you code, while retaining the deep technical skepticism required to audit, verify, and own its output.
• You are a collaborative builder. You have low ego, high standards, and excellent communication skills. You thrive in cross-functional environments where engineering requirements are heavily shaped by healthcare regulations, compliance, and patient safety.
• You are excited to work in-person. You want to build alongside the team 5 days a week in our San Francisco office.
• If you are targeting Staff leveling: We expect a demonstrated track record of setting technical direction across teams, navigating deep ambiguity, and measurably leveling up the engineers around you.

Our Process

1. Intro call (30 min, remote) — Chat with our recruiter about the role and expectations.
2. Technical round (2 hrs, remote) — Practical coding (AI tools welcome) + system design conversation. Real problems, not LeetCode.
3. Behavioral interview (45 min, remote) — Technical background, motivation, and what you're looking for.
4. Team meet (2 hrs on-site) — Come to our SF office to meet your future manager, engineering peers, and product partners for 30-minute 1:1s, concluding with a quick recruiter wrap-up.

Life at Mochi Health

Time to Recharge – Enjoy unlimited PTO, generous company holidays, and true flexibility. We trust you to take the time you need to rest, reset, and thrive

Wellness First – From weekly mindfulness sessions to group workouts and fitness perks, your physical and mental health are top priority

Team Socials and Community - We make time to connect through regular socials, happy hours, and spontaneous events. Our stocked kitchen doesn't hurt either

Downtown SF HQ - Our San Francisco office is just steps from BART, Muni, and great food. It's designed for deep work and casual collaboration