Staff Software Engineer
About Primum
Community oncologists care for 80% of cancer patients, and no one can keep pace with oncology alone. Primum connects them to the experts who can, so treatment decisions get made with the best information available.
We are a small startup. What you do here reaches oncologists quickly, and the decisions you make stick.
About the Role
You’ll own the technical problems that cross system boundaries and don’t have an obvious owner, ship the features oncologists use, and make the engineers around you better. You’ll work directly with founders, designers, and engineers, and stay close to both the code and the people using it.
Our platform spans web and mobile apps, backend services, data infrastructure, and AI. We’re TypeScript end to end, on AWS, with a monorepo per surface.
Most of your time goes to the product. Our experts are oncologists, and we use AI to get their expertise to the community oncologists who need it. Where AI fits, and how far it goes, is still open, and you’ll help decide.
The rest of your time goes to how we build. Coding agents are already central to how we work. What we need is judgment about what to hand to an agent, when to stay hands-on, and how to know the output is right.
What You’ll Do
Build the Product
- Build features for our web and mobile apps (iOS, Android, and browser) with React, React Native, and Expo, on a shared design system.
- Design APIs and data models with Node.js and Postgres, and model long-running work as Temporal workflows.
- Wire in the services the product runs on, like Twilio and OneSignal.
- Keep our AWS footprint secure and scalable, managed with Pulumi and shipped through GitHub Actions.
- Instrument what you ship through Segment and our Snowflake warehouse, so we can tell whether it worked.
Scale Expert Judgment with AI
- Build AI features that help our expert oncologists reach more clinicians, rather than trying to replace what they know.
- Bring emerging AI practices to the product and help decide where they belong.
Optimize How We Build
- Keep our agent-assisted development setup current as the tooling changes. Success is how fast we ship, how well it holds up in production, and whether the team actually uses what you build.
- Own the checks that stop speed from costing us quality: test strategy, review norms, observability, and the conventions both people and agents work from.
Work With the Team
- Work with product and design to shape features, raising technical tradeoffs early rather than after the fact.
- Pick up whatever the problem needs, whether that’s a bug fix, a new feature, a redesign, or an incident in production.
What Success Looks Like in Your First Six Months
- You’ve shipped something complex that solved a real problem for oncologists, from shaping the approach through supporting it in production.
- You’ve shipped an AI capability that helped our experts reach more oncologists.
- You’ve removed a recurring bottleneck and left behind the tooling or documentation that stops it coming back.
What We’re Looking For
- Deep full-stack experience owning complex systems end to end, long enough to have lived with your own architectural decisions as they aged.
- Time at a startup or high-growth team, and a bias for action when the path isn’t mapped out.
- Real experience building with coding agents, and opinions about where they help and what has to be true before you trust their output in production.
- Experience shipping AI features to real users, and a way of proving they work.
- You instrument what you ship and change your mind when the numbers disagree with you, and you know when the data isn’t there yet and the call is yours anyway.
- More interest in the user’s problem than in the stack you solve it with, and the care for detail that treatment decisions demand.
Bonus Points For
- Shipping to the App Store and Play Console with Expo.
- Healthcare, or another heavily regulated industry.
- Building alongside domain experts and turning what they know into product.
- Staff or principal-level IC experience in a small engineering org.
- Being in Columbus, OH, though the engineering team is fully remote.
Why Join Primum?
- Join early enough to shape both the product and how the engineering team works.
- Work with a small team of engineers, designers, analysts, and product people who take the work seriously.
- Build AI that extends what expert oncologists can do, rather than replacing them.
- Competitive salary, equity, and benefits.
Or email us directly at hello@primum.co