Senior Full-Stack Engineer

Senior Full-Stack Engineer at Duet

About Duet

Duet is proving that nurse-practitioner-led care isn't just more accessible, it's better. We help NPs build and scale independent practices in communities too often overlooked by the health system: rural towns, immigrant populations, LGBTQ+ patients, and more. Backed by AI-driven tools that give independent NPs the backing of a much bigger system, our network of 100+ practices covering 400,000 annual visits has driven a 30% increase in preventative visits and a 35% drop in hospitalizations, the clearest sign yet that localized NP-led care means better outcomes.

We're a well-funded, early-stage company led by seasoned entrepreneurs and nurse practitioners, and backed by investors including Lerer Hippeau and Kairos.

Why Duet, Why Now

Independent primary care is disappearing, swallowed by hospital systems and private equity roll-ups, often pulling out of the communities that need it most. But 31 states now support autonomous NP practice, and the results back up what we've long believed. We built the first value-based care contracts for NPs with major payors, taking on real financial risk for outcomes. In our anchor market in New Hampshire, our network outperformed the state on total cost of care by 19%, proof that a solo NP in an underserved area can outperform a system ten times their size and get rewarded for it.

Overview

We're a well-funded seed-stage company led by experienced entrepreneurs and Nurse Practitioners, backed by Kairos HQ, Lerer Hippeau, and others. Duet is building a vertically integrated enablement platform for NP-led practices: software that reduces administrative overhead, improves cash flow, and gives clinicians leverage to operate sustainable businesses without corporate consolidation.

We've already built the data foundation that connects to outpatient EHR and practice management systems and supports these workflows through services today. This role is about turning that foundation into scalable, self-serve products—automating work away and putting control directly in the hands of practices.

About the Role

As a Senior Full-Stack Engineer, you'll design, build, and maintain the systems that power Duet's customer-facing products. This is an IC-heavy role focused on backend architecture and workflow logic, with enough frontend exposure to ensure excellent end-user experiences. You'll report directly to the founding team.

You'll work on the systems that enable rule-driven and customer-configured automation, web-based experiences for clinic staff, and operational workflows that replace manual, error-prone processes.

This role sits at the intersection of product, data, and systems engineering, and is ideal for someone who enjoys building flexible primitives that multiple products can be composed from

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What You'll Do

Build Product-Enabling Systems. Design and implement backend systems that support configurable workflows and automation. Create primitives that allow multiple products to be built on top of shared logic. Balance flexibility with simplicity so systems remain understandable and maintainable.

Turn Services Into Software. Work closely with operations and product to understand how work is done today. Identify patterns in manual processes and translate them into durable software abstractions. Iterate quickly based on real usage from practices.

Own Quality & Reliability. Write thoughtful tests for workflow logic and core systems. Debug production issues and improve systems based on failure modes. Ensure changes are safe, observable, and reversible.

Set the Software Foundation. Influence architectural decisions and engineering standards. Help onboard new engineers and contribute to a culture of ownership and clarity. Act like a builder, not a ticket-taker.

What We’re Looking For

• 6+ years of experience building production web-based software.
• Strong background in backend or full-stack engineering, with experience working on systems that support complex business logic or workflows.
• Proficiency in Python, Javascript, and experience building and consuming RESTful APIs.
• Comfort working across the stack, with backend as your strength.
• You’re comfortable with rule-based and user-configured systems.

Nice To Haves

These aren't required, but healthcare or billing experience will meaningfully accelerate your impact. Similarly, experience turning internal tools or services into customer-facing products, or building data-heavy admin tooling, maps directly to what we're doing.

What this role offers

High ownership: Build foundational systems as an early engineer, reporting directly to founders.

Real users: Clinics use what you ship every day.

Product-led: You'll work on features customers actually see and feel.

Mission-driven: Support independent primary care at a critical moment.

This role is hybrid in NYC (in office Monday-Wednesday). The salary range for this role is $160,000-$185,000 per year plus equity.