Director of Engineering – Ruby on Rails (EMR Platform)

About the Opportunity

We are partnering with a growing healthcare technology organization to identify a highly technical, hands-on Engineering Leader to take ownership of a core Electronic Medical Records (EMR) platform.

This role sits at the center of a live, production healthcare system supporting clinical workflows, patient data, and revenue cycle operations.

We’re looking for a leader who operates as an architect and senior engineer first—someone who can modernize and scale a complex platform while leading a distributed team and elevating engineering practices.

Technical Environment

You’ll be working within a real-world, production EMR platform with:

• Ruby on Rails–based application (backend-heavy)
• Relational databases (PostgreSQL/MySQL) with complex healthcare data models
• API-driven integrations across healthcare and business systems
• Containerized infrastructure (Docker, Kubernetes)
• Cloud-hosted environments (AWS, Azure, or similar)
• CI/CD pipelines with opportunity for continued maturity
• High standards for data integrity, security, and system reliability

What You’ll Do

Platform Ownership & Architecture

• Own and evolve a Ruby on Rails EMR platform end-to-end
• Lead system design across backend services, APIs, and data models
• Modernize legacy components, including modularization or service decomposition
• Drive improvements in performance, scalability, and fault tolerance
• Establish best practices for testing, code quality, and maintainability

Hands-On Engineering Leadership

• Stay close to the code—contributing directly in complex or high-impact areas
• Lead technical decision-making across:
  • Database optimization and query performance
  • API design and integration patterns
  • Background job processing and asynchronous workflows
  • Data consistency and transactional integrity
• Conduct deep code reviews and architecture sessions

Infrastructure & DevOps

• Advance containerized and cloud-native practices
• Optimize environments using:
  • Docker
  • Kubernetes
• Improve CI/CD pipelines, deployment automation, and release processes
• Strengthen monitoring, logging, and alerting for production systems
• Ensure infrastructure aligns with security and compliance expectations

Distributed Team Leadership

• Lead and mentor a nearshore engineering team (~6 engineers in Mexico)
• Drive engineering consistency across a distributed delivery model
• Lead sprint execution, technical planning, and accountability
• Coach engineers on architecture, system design, and best practices

Strategic Engineering Impact

• Define and execute the technical roadmap for the platform
• Reduce technical debt while improving system longevity
• Ensure scalability to support future product growth and integrations
• Contribute to broader technology strategy within a healthcare ecosystem

What We’re Looking For

Core Technical Expertise

• Deep, hands-on experience with Ruby on Rails in production
• Strong background in backend architecture, RESTful APIs, and service design
• Experience with relational databases and performance tuning
• Strong understanding of:
  • Object-oriented design and design patterns
  • Domain-driven design (DDD)
  • Data modeling and schema design

Modern Engineering & Infrastructure

• Experience with Docker and Kubernetes
• Familiarity with AWS, Azure, or GCP
• Experience building or optimizing CI/CD pipelines
• Understanding of scalable systems and distributed architecture

Leadership

• Proven ability to lead engineering teams while remaining hands-on
• Experience working with distributed/nearshore teams
• Strong communication across technical and business stakeholders

Nice to have

• Spanish bilingual (to collaborate effectively with the Mexico-based team)

Preferred

• Experience with EMR/EHR or healthcare technology platforms
• Familiarity with clinical workflows, patient data, or revenue cycle systems
• Exposure to HIPAA or regulated environments
• Experience modernizing legacy or monolithic systems
• Background in SaaS or scaling product environments

Why This Role Stands Out

• Ownership of a mission-critical healthcare platform
• Highly technical role with real system complexity
• Opportunity to shape architecture, infrastructure, and engineering culture
• Blend of hands-on engineering and strategic leadership
• Strong compensation with growth potential

Interested in learning more?

We’re actively engaging with candidates and would welcome a conversation.