Software Engineer II, L2 Messaging Team

About CareMessage

CareMessage is a technology non-profit dedicated to improving health equity for 5 million people. We build the largest patient engagement platform for low-income populations in the United States, utilizing our Health Equity Engine™ to connect organizations with messaging, data, and interoperability solutions. Our platform aims to increase access to care, enhance clinical outcomes, and address social determinants of health. Since 2013, we've reached 20 million patients, making us a proven leader in health equity at scale. Our nonprofit model reinvests revenue into our mission, partnering with organizations committed to advancing health equity.

Who We're Looking For

We are seeking a Software Engineer II (L2) for the Messaging Team to contribute to our core patient communication platform, serving over 400 safety-net healthcare organizations. In this role, you will complete scoped work with guidance from senior engineers, develop independence on well-defined features, and contribute to team objectives within a collaborative, supportive environment as we scale our messaging infrastructure.

This cross-functional role involves close collaboration with Product, Customer Success, Data, and Engineering teams to deliver messaging features that enhance patient engagement and health outcomes. You will work alongside senior teammates on delivery optimization, consent management, and AI-driven messaging. Reporting to the Director of Engineering, you will play a crucial role in scaling our messaging capabilities.

Who You Are

You are a developing backend engineer adept at working in dynamic, fully distributed environments. You possess solid experience with Ruby on Rails and are motivated by the challenge of building reliable, patient-centric communication infrastructure. You are eager to expand your expertise under the mentorship of senior engineers, keen to apply your skills to real-world challenges like delivery optimization, consent management, and AI-driven messaging, and open to acquiring new knowledge.

You approach all tasks with a scientific mindset, relying on evidence rather than intuition and seeking data that challenges assumptions before reaching conclusions. You contribute to PRDs, documentation, and wikis with this same data-driven approach, using evidence to guide decisions and validate your work. You are enthusiastic about operating in a mission-driven, fast-paced environment and bring a collaborative, curious attitude to your work. Above all, you share our commitment to advancing health equity for low-income populations and take pride in contributing to this mission through the systems you build.

Core Requirements

• Minimum 5 years of hands-on software engineering experience, with solid proficiency in Ruby on Rails and JavaScript.
• Minimum 5 years' experience building and maintaining backend systems, APIs, and services, with demonstrated experience completing scoped work with growing independence.
• Solid fundamentals of computer programming, including a good understanding of software development lifecycle, coding best practices, design patterns, object-oriented architecture, etc.
• Working SQL proficiency with a strong analytical mindset, comfortable querying and working with datasets to troubleshoot issues and inform technical decisions.
• A commitment to supporting and fostering diversity and inclusion.
• Demonstrated ability to complete scoped work with guidance, follow established patterns, participate in code reviews, and grow toward independent ownership of well-defined features.
• Growth-oriented mindset.
• Outstanding written and verbal communication skills, especially in a fully remote environment.
• Ability to collaborate with technical and non-technical partners to support discovery, development, and testing phases of messaging platform features.
• Experience working in teams where automated tests are an expected part of development, including writing and maintaining tests alongside production code.
• Ability to communicate progress and blockers clearly, ask for help when stuck, and maintain consistent communication with stakeholders to keep projects moving forward.

Preferred Experience

• Experience with Twilio (SMS, Voice, or Messaging APIs) or similar messaging and communications platforms.
• Experience with RCS (Rich Communication Services) or multimedia messaging (MMS).
• Experience with our tech stack: Ruby on Rails, JavaScript (React), PostgreSQL, Google Cloud Platform, background job processing (Sidekiq or similar).
• Experience with message queue systems, event-driven architecture, or high-throughput delivery pipelines.
• Experience in healthcare technology or familiarity with messaging compliance requirements, including TCPA, opt-out management, consent workflows, A2P 10DLC, and The Campaign Registry (TCR).

Role Responsibilities

• Contribute to the technical delivery of key messaging platform features, collaborating with Product, Customer Success, Data, and Engineering to build solutions that deepen patient engagement and health outcomes.
• Build and maintain backend messaging systems using Ruby on Rails, including SMS/voice delivery pipelines, consent management workflows, message scheduling and orchestration, and Twilio integration layers.
• Participate in team rituals and discussions, give and receive code reviews, and grow ownership of well-defined features under the guidance of senior engineers.
• Contribute to architectural discussions and learn from design decisions shaping our messaging infrastructure, including delivery optimization, AI-driven message categorization, and multimedia messaging (MMS/RCS).
• Provide documentation for messaging features, enabling support teams to monitor, troubleshoot, and measure feature impact in production.
• Work closely with Product teams to understand requirements, contributing technical input during solution definition and collaborating on Product Requirements Documents (PRDs).
• Help improve the team through essential rituals like Kickoffs, Retrospectives, and Technical Debt Reviews.
• Participate in On-Call (PagerDuty) activities.

Within 1 month you will:

• Have a working familiarity with CareMessage's messaging platform, features, and API.
• Understand our messaging infrastructure, Twilio integration, and Software Development Lifecycle at a working level.
• Learn and follow CareMessage's engineering standards, coding best practices, and development processes.
• Establish rapport with engineers on the team through Wiki contributions, 1:1 conversations, and Team Rituals.
• Begin reviewing PRs and participating in technical design discussions.

Within 3 months you will:

• Be independently completing scoped messaging features with guidance from senior engineers.
• Have a working understanding of our messaging architecture and be familiar with our processes, systems, and tooling.
• Understand our Company Objectives and Key Results and be able to articulate how the Messaging team contributes to them.
• Be giving and receiving code reviews regularly and asking for help when stuck.
• Have begun contributing to technical design discussions.

Within 6 months you will:

• Be a trusted contributor on the Messaging team, having developed strong rapport with peers and cross-functional partners.
• Have growing independence on well-defined messaging features from build through production support, contributing to projects that directly impact patient outcomes.
• Participate actively in team rituals and technical design sessions, following established patterns and team standards.
• Be building depth in one or more areas that drive value for the Messaging team (e.g., delivery pipelines, consent workflows, Twilio integrations, MMS/RCS).

Working at CareMessage

We prioritize our employees' well-being with competitive salaries and benefits. We ensure our team feels supported so they can, in turn, support our safety net organizations and underserved populations.

• Fair and equitable compensation.
• Flexible work hours; fully remote team.
• Equal work for equal pay: all team members performing the same role at the same level are paid similarly, regardless of location.
• Paid parental leave for biological and adopted children.
• Time off to thrive:
  • Half-day Fridays, every Friday.
  • 18 paid company holidays, including a one-week mid-year and one-week end-of-year break.
  • 9 wellness days for self-care or life events.
  • 15 days of PTO.
  • 1-month (20 working days) paid sabbatical after the 4-year anniversary, and every 4 years thereafter.
• Support for health, wellness, and growth:
  • Generous medical, dental, and vision insurance for employees and their families.
  • Health Savings Accounts and Flexible Spending Accounts.
  • 401k retirement plan.
  • Short & long-term disability insurance.
  • $100 yearly wellness budget per employee for physical, emotional, and mental wellness resources.
  • PerkSpot: Instant access to discounts on products & services.
  • Annual budget for professional and personal development (webinars, online courses, books, etc.).
• Volunteerism incorporated in onboarding and encouraged ongoing.

Note: If you do not meet every requirement but believe you can succeed in this role, especially if you come from an underrepresented background, we encourage you to apply.

As a healthcare technology company, we value innovation. While AI can be a helpful assistant, your unique skills are paramount. Our interview process assesses individual abilities, critical thinking, and problem-solving. We encourage candidates to ensure their work reflects their own experiences and approach. We're excited to learn more about you!