Staff Software Engineer, Billing & Payments

Responsibilities

You will lead the technical direction for the billing and payments platform, focusing on centralizing pricing logic and decoupling billing services. You will also mentor engineers, define system architecture, and partner with cross-functional teams to ensure financial correctness and scalability.

Requirements

The ideal candidate has 8+ years of experience building production systems with Ruby on Rails, React, and PostgreSQL in a cloud environment. You must demonstrate strong leadership in ambiguous problem spaces and have a deep understanding of financial system requirements like auditability and observability.

Skills

• Ruby on Rails
• React
• PostgreSQL
• Docker
• AWS
• System architecture
• API design
• Data modeling
• Financial systems
• Billing
• Payments
• Technical leadership
• Mentoring
• Observability
• Auditability
• AI integration

Benefits

• Equity
• Annual bonus
• Flexible working hours
• Generous time off
• Paid parental leave
• Health insurance
• Vision insurance
• Dental insurance
• Employee Assistance Programs
• 401K retirement plan
• Flexible PTO
• Summer Fridays
• Paid holidays

About this role

At Carrum Health, we have built a unique marketplace for specialty care with
unparalleled patient experience

Since 2014, we have been rewiring a fundamentally broken healthcare system. By
connecting large employers directly with the nation's top-tier providers, our
platform replaces a flawed fee-for-service model with one that actually works.
If you are passionate about solving complex economic problems, driving systemic
change in our healthcare system, and thriving in a people-first culture, we want
you on our team. As a high-growth health tech company, we are seeking
high-performing, exceptional talent to scale our platform and ensure that anyone
in the country facing a specialty procedure has access to the life-changing
Carrum benefit. 

Our marketplace creates massive value for all stakeholders:

* For Employers (Demand): Predictable, transparent pricing that slashes
specialty care costs by up to 45% and eliminates waste

* For Providers (Supply): Ability to gain market share while reducing
administrative burden, empowering top-tier doctors to focus completely on
delivering optimal care.

* For Members (Users): A life-changing benefit with dedicated concierges, VIP
access to the nation's best specialists, and little-to-no out-of-pocket
costs.

The salary range for this role is $210,000 - $250,000 depending on geography and
level of experience, plus equity and an annual bonus.

As a Staff Software Engineer on our billing and payments platform, you will set
the technical direction for the systems that price, bill, and pay for every
episode of care that runs through Carrum. That includes:

* Bundled pricing and contracts

* Invoicing and provider payments

* The financial data our Finance and Operations teams rely on

Today, pricing and billing logic is spread across several services. That makes
pricing changes slower than they should be, and it makes financial correctness
harder to guarantee. Your first big job is to change that. You will centralize
pricing into a single pricing service, define clear service boundaries and data
models for billing, and lay a foundation that supports new service lines without
a rewrite.

You will work primarily in Ruby on Rails in a Service-Oriented Architecture,
with React on the front end and PostgreSQL underneath. You will partner with
Product, Finance, Operations, and Data. You will also be the engineer others
come to when a problem crosses pods or ownership is unclear.

You’re excited about this opportunity because you will...

* Own the technical vision for billing and payments, and turn it into a plan
that ships in increments instead of a big-bang rewrite.

* Lead the work to centralize pricing into a single source of truth and
decouple billing from the systems it is tangled up with today.

* Own revenue-critical systems end to end. Make them correct, observable, and
safe to change, and catch problems before Finance or our clients do.

* Partner with Product and Finance to shape the roadmap, question requirements
early, and explain engineering tradeoffs in business terms.

* Lead technical initiatives that span more than one team, without needing
positional authority to get them done.

* Write the design docs, ADRs, and diagrams that become the reference for how
billing works at Carrum.

* Grow the engineers around you through design reviews, code reviews, and
mentoring that improves decisions, not just code.

* Help set how we use AI in a domain where correctness matters. Apply it where
it creates leverage, and put guardrails where it does not.

We’re excited about you because…

* You have 8+ years building and running production systems, and you can point
to outcomes you drove, not just time served.

* You have led technical initiatives across multiple teams in ambiguous problem
spaces, from framing the problem through measurable results.

* You have designed APIs and data models that serve multiple consumers, and you
know how to evolve them without breaking the people who depend on them.

* You have production experience in our core technologies: Ruby on Rails
(distributed architecture), React, PostgreSQL, Docker, and a major cloud
platform (we run on AWS today).

* You treat financial correctness, auditability, monitoring, and safe rollback
as core requirements, not afterthoughts.

* You make tradeoffs explicit, separate essential from accidental complexity,
and know when "good enough for now" is the right call.

* You can explain complex systems to non-technical stakeholders as clearly as
to engineers, and you build trust through follow-through.

* You use AI tools every day to design, build, debug, and document, and you own
every line you submit.

* You are entrepreneurial and resourceful. As a member of a startup, we need
people who can find creative ways to make a big impact quickly and without
much direction.

* Note that we left out all of the other nonsense and standard gibberish you
see in every JD, so please tell us you read this far. You will get points for
it. Seriously.

NICE TO HAVE

* Experience with billing, invoicing, payments, or other financial systems.

* Healthcare payments experience: bundled or value-based pricing, claims, or
provider reimbursement.

Why you’ll love working with us...

* We’re a hard-working, humble, and compassionate group motivated to solve the
hard problems in healthcare today. You’ll work with talented, experienced
co-workers from companies like Booz & Company, Teladoc, Hinge Health,
Accolade, Angi, and Optum. 

* We champion a collaborative environment where team members can be autonomous,
receive support and healthy feedback, and bring their authentic selves to
work.

* We carve out time to celebrate our successes and have fun. We’re a
remote-first company with employees all over the United States. We offer
holistic employee support with flexible working hours, gen...

About Carrum Health

Hospitals and Health Care · 201-500 employees · headquartered in San Francisco, California · founded 2014