Senior Software Engineer (AI-Native) - Healthcare Platform

Senior Software Engineer (AI-Native) — Healthcare Platform

Location: Remote across India (US Pacific overlap 4-8hrs daily)

Type: Full-time

Reports to: Lead Engineer / Founder-CEO

Compensation: ₹20–40 LPA (higher for exceptional candidates — prove it)

About the Company

Zenara Health is a technology-focused mental healthcare company committed to improving access to and the quality of mental wellness services. By integrating AI-driven platforms with expert clinical care, we offer personalized and effective mental health solutions, connecting patients with providers through an efficient digital platform. We are rapidly developing multiple products throughout the clinical workflow, from AI-driven assessments to care coordination. As a startup, we operate like a dynamic team rather than a conventional department.

About the Role

Please read carefully: if you're the type of developer who waits for Jira tickets and inquires “what should I build next?” you can stop reading here. Our Lead Engineer serves as the technical backbone of the company, overseeing the billing subsystem, FHIR/EHR integration, product frontend, claims lifecycle, and clinical workflow architecture. He is remarkably talented, but he can only do so much alone. We need a counterpart to him. This is not a role for someone who merely "assists" or "supports." We are looking for an individual who can collaborate with him, quickly absorb his expertise, and take full ownership of entire subsystems within 90 days. You will initially focus on understanding the most intricate and essential components of our platform before stepping into a shared leadership role over the architecture and contributing to new product development. The progression is as follows: apprentice (month 1) → co-owner (month 2) → owner (month 3) → architect (month 4+).

This is not a junior-to-mid role with a senior title. We are seeking someone who has experience delivering complex systems, thinks architecturally rather than just in terms of code, and uses AI tools so skillfully that they can release features at two to three times the speed of a typical developer. If you do not already use Claude Code or GitHub Copilot daily, you may not be able to keep up with your future colleague.

As the founder-CEO is a physician, you'll learn about healthcare organically, including billing codes, clinical workflows, and HIPAA regulations. What we cannot teach you is the engineering intuition: knowing when to refactor versus when to ship, designing systems that can be maintained by other engineers, and having the initiative to take ownership of results without requiring supervision.

Requirements

Required

• 4-8 years in full-stack software engineering — experience with shipping production SaaS applications, not agency websites or internal tools.
• Proficiency in TypeScript — it’s not just that you've used it; you think in TypeScript. Concepts like generics, utility types, strict mode, and discriminated unions come naturally to you.
• Experience with React + Next.js — working on production applications rather than tutorial projects, with knowledge in SSR, API routes, dynamic routing, and performance optimization.
• Node.js backend skills — familiarity with REST APIs, authentication, middleware, error handling, and background job management.
• Prisma ORM + PostgreSQL experience — including schema design, migrations, query optimization, and relation modeling.
• Mastery of Git — understanding branching strategies, maintaining a clean commit history, managing PR workflows, and rebasing. Your git log should serve as documentation.
• Experience with AI-assisted development — daily engagement with tools like Claude Code, GitHub Copilot, or their equivalents, and the ability to explain how AI has influenced your development process, beyond simply stating that you use it for autocomplete.
• Self-motivated work style — you thrive in environments where tasks are not assigned, identifying what needs to be built and executing on it.
• Strong English communication skills — with an async-first approach, including the ability to produce clear written documentation, PR descriptions, and technical decision records.

Strongly Preferred

• Experience with healthcare SaaS (e.g., billing, EHR, clinical workflows, HIPAA compliance).
• Familiarity with FHIR/HL7 standards.
• Knowledge of Server-Sent Events (SSE) or WebSocket real-time architecture.
• Understanding of multi-tenant SaaS security (e.g., RBAC, row-level security, tenant isolation).
• Experience with Azure cloud services (App Service, Azure SQL, Blob Storage).
• A quick learner when it comes to complex domain knowledge from subject matter experts.

Nice to Have

• Knowledge of behavioral health or medical billing.
• Experience with AI/ML pipeline integration.
• Familiarity with startup environments — comfortable with ambiguity, rapid pivots, and taking on varied roles.
• Experience working in a very small engineering team.
• Familiarity with medical billing codes (CPT, ICD-10).

Schedule

In practice, this means working approximately 2pm–12am IST (or similar). Your mornings are your own. Deep coding sessions take place in the afternoon, and you will have overlap with the US team in the evening. If you have evening commitments that conflict with this schedule, this role may not be suitable for you. We emphasize the importance of uninterrupted focus time — you propose your own schedule. We prioritize output and collaboration over strict timekeeping. You will need to maintain 4–8 hours of daily overlap with the US Pacific time zone (9am–5pm PT).

Benefits

• Salary range of ₹20–40 LPA based on skills and experience
• Fully remote work available within India
• Equipment allowance
• Budget for learning—covering tools, courses, and conferences
• Direct communication with the Lead Engineer and Founder-CEO—no intermediaries involved
• Encouraged use of AI tools to enhance productivity—utilize whatever makes your work more efficient
• Opportunity to manage a key subsystem in a healthcare organization from the outset—no waiting for years to demonstrate your value