Senior Full stack Engineer

• Senior Full Stack Engineer – Healthcare Claims Platform
• The Problem We're Solving

Right now, a patient walks into a pharmacy needing $15,000/month medication for a chronic condition. The pharmacist submits a claim. Within seconds, our platform needs to: verify patient eligibility across many manufacturer programs, apply the correct copay assistance, process the claim through NCPDP protocols, and get money to the pharmacy—while maintaining HIPAA compliance and audit trails. When this works, patients get life-saving medication. When it breaks, they don't.

We're Medmonk, and we've built the infrastructure connecting pharmaceutical manufacturers with patients who need financial assistance. We're looking for an engineer who gets excited about complex systems problems with direct human impact.

• What Makes This Hard

This isn't standard CRUD work. You'll be dealing with:

· Real-time claims processing where sub-second response times matter and transaction integrity is non-negotiable

· Multi-tenant architecture serving manufacturers, providers, patients, and admins—each with different data access patterns and compliance requirements

· Healthcare standards integration (NCPDP, EDI) that are poorly documented and require domain expertise to implement correctly

· High-stakes reliability where bugs don't just break user experience, they prevent patients from accessing medication

You'll need to balance moving fast (we're scaling rapidly) with getting it right (healthcare data and financial transactions).

Build the core platform features that keep claims flowing:

· Architect and implement claims processing pipelines that handle pharmacy transactions in real-time

· Design APIs and data models that support complex eligibility rules, multi-program enrollment, and role-based access across four different user portals

· Optimize query performance and background job systems that process thousands of claims daily

· Work directly with product and healthcare operations to translate messy real-world requirements (manufacturer contracts, pharmacy workflows, patient assistance rules) into reliable code

· Own technical decisions for your domain—we need engineers who can evaluate tradeoffs and push back when requirements don't make sense

You Should Have

The fundamentals:

· 7+ years of production full stack development experience building and scaling web applications

· Production experience building and scaling Rails applications (Rails 7/8 preferred, but we care more about depth than version numbers)

· Strong React skills with modern patterns—you're comfortable with hooks, state management, and know when to reach for different tools

· Database design experience with MySQL/PostgreSQL—you understand indexes, query optimization, and schema evolution

· Real testing discipline (RSpec, Jest/Cypress)—not just writing tests, but designing testable systems

The mindset:

· You've debugged complex distributed systems and know how to instrument code for observability

· You think about API design from the consumer's perspective

· You have opinions about code architecture but aren't religious about them

· You can read unfamiliar code, understand it, and improve it

Strong signal if you have:

· Healthcare, insurance, or financial transaction processing experience (the domain knowledge genuinely helps)

· Built multi-tenant systems with complex RBAC requirements

· Worked with background job systems at scale (Sidekiq, Solid Queue)

· HIPAA compliance or healthcare data security experience

Why This Role Might Interest You

· Impact clarity: Your code directly affects whether patients access medication they need to survive

· Technical depth: You'll work on genuinely hard problems—real-time transaction processing, complex eligibility logic, healthcare protocol integration

· Ownership: We're looking for senior engineers who can own problem spaces, not just complete tickets

· Modern stack with purpose: Rails 8, React 18, TypeScript—but in service of solving actual problems, not chasing trends

Tech Stack Rails 8 • React 18 + TypeScript • MySQL • Elasticsearch • Solid Queue • Docker • AWS • New Relic/Sentry

What We're Not

· We're not a FAANG-style process with Leetcode puzzles

· We're not looking for someone to blindly execute a backlog

· We're not optimizing for maximum scale—we're optimizing for reliability and patient outcomes

Job Type: Full-time

Pay: Rs300,000.00 - Rs350,000.00 per month

Work Location: In person