Staff Software Engineer
About Primum
At Primum, we’re on a mission to ensure every cancer patient receives the most informed and effective treatment possible. Community oncologists care for 80% of cancer patients and face constant challenges staying up to date with the latest oncology advances. Primum's platform connects them to expert advice and cutting-edge insights, empowering better treatment decisions and improving lives.
We are a fast-moving startup where every team member has outsized impact. If you thrive on solving problems, love details, and want to build something that matters, this is your chance.
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. The rest goes to how we build it. Coding agents are already central to how we work and we have a solid foundation to build on, so 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, TanStack Query, and a shared Tailwind design system.
- Design APIs and data models with Node.js, Hono, Drizzle, Zod, and Postgres, and model long-running work as Temporal workflows.
- Build with Claude and the Anthropic API where AI genuinely helps our users, and wire in the services around it: Algolia, Segment, Twilio, OneSignal.
- Keep our AWS footprint (ECS Fargate, Aurora Serverless, S3, Cognito, CloudWatch) secure and scalable, managed with Pulumi and shipped through GitHub Actions.
- Instrument what you ship through Segment, Mixpanel, and our dbt and Snowflake warehouse, so we can tell whether it worked.
- Set technical direction and raise the level of the team through code review, pairing, and design discussion.
Optimize How We Build
- Build on our agent-assisted development setup and keep it current as the tooling changes. Success is how fast we ship, how well it holds up in production, and whether the rest of the team actually uses it.
- Own the checks that stop speed from costing us quality: test strategy across Vitest and Playwright, review norms, observability through Sentry and OpenTelemetry, 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 a complex improvement that solved a real problem for oncologists, from shaping the approach through supporting it in production.
- You’ve changed how we use coding agents in a way other engineers picked up and kept using.
- You’ve removed a recurring bottleneck and left behind the tooling or documentation that stops it coming back.
What We’re Looking For
- 7+ years building software, including full-stack work, with a track record of owning complex systems end to end.
- 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, where they don’t, and what has to be true before you trust their output in production.
- An obsession with data. You instrument what you ship, check whether it worked, and change your mind when the numbers disagree with you.
- Comfort trusting your gut when the data isn’t there yet, and the judgment to know which of the two situations you’re in.
- Genuine curiosity, and more interest in the user’s problem than in the stack you solve it with.
- An eye for detail, because when oncologists are making treatment decisions, the details matter.
Bonus Points For
- Shipping to the App Store and Play Console with Expo.
- Healthcare, or another heavily regulated industry.
- Staff or principal-level IC experience setting technical direction across a small engineering org.
- Living in Columbus, OH, or willing to be here in person regularly.
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 thinkers who take the work seriously.
- Solve genuinely hard problems on a product doctors use to make treatment decisions.
- Hybrid in Columbus or fully remote, whichever works for you.
- Competitive salary, equity, and benefits.
Or email us directly at hello@primum.co