As a Senior Full Stack Engineer on the Care Team, you will join a team that is working to improve patients’ lives through a better pharmacy experience. The Care Team owns the services that manage all of prescription processing from intake up to the moment we send an order to our pharmacies for fulfillment. The key focus areas for the Care Team include:

Preparing prescriptions for fulfillment and delivery as quickly and accurately as possible through a combination of automation and efficient manual task coordination when third party input is required to advance a fill

Enabling the growth of the business by enabling partners like drug manufacturers, insurers, and individual providers to easily configure billing, benefits, and clinical workflows tailored to their use cases


Example Projects:

Increase Alto’s intake automation rate by leveraging LLMs to parse unstructured data from prescriptions
Accelerate pharmacist workflows by integrating controlled substance dispensing history and risk scores into our pre-dispense clinical safety and review step
Optimize the selection of which drug to dispense to find patients the best price

Job Description

Accelerate Your Career as You

• Excited about balancing low inventory on hand with high availability

• Establish the foundations for an extensible inventory management platform to fuel business growth

• Mentor other engineers, encouraging best practices in software development and design

• Solve complex technical problems at the intersection of healthcare and e-commerce

• Thought leader on how to build world class predictive systems

A Bit About You

Minimum Qualifications:

• Bachelor's degree in Engineering or equivalent experience

• 8+ years of progressive software engineering experience in a high volume, high throughput production environment

• Background in Backend or Full Stack technologies

• Expertise in architecting complex systems for long-term maintainability, performance, and scalability

• Strong engineering fundamentals and experience building high volume, high throughput, resilient systems.

• Proven track record of technical best practices, including code style, documentation, code review, bug fixing, and production issue mitigation.

• Relentless in pursuing impact through their work.

Preferred Qualifications:

• Solid experience with supply chain optimization systems.

• Proficiency in Alto's tech stack: Rails, Python, and PostgreSQL.

• Experience building and integrating predictive ML models.

• Demonstrated ability to thrive in a dynamic entrepreneurial environment and maintain a growth mindset.

• A pragmatic approach to problem solving that’s biased towards impact.

• A strong sense of ownership over your work and a desire to uplevel your peers.

• Passion for Alto’s mission and our company values.

• Experience designing and implementing service oriented architectures.

Additional Information

Additional Physical Job Requirements

• Read English, comprehend, and follow simple oral and written instructions. The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading. Assessing the accuracy, neatness and thoroughness of the work assigned.

• Communicating with others to exchange information. Expressing or exchanging ideas by means of the spoken word; those activities where detailed or important spoken instructions must be conveyed to other workers accurately, loudly, or quickly.

• Perceiving the nature of sounds at normal speaking levels with or without correction, and having the ability to receive detailed information through oral communication, and making fine discriminations in sound.

• Frequent repeating motions required to operate a computer that may include the wrists, hands and/or fingers.

• Sedentary work: Sitting most of the time, exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Walking and standing are required only occasionally.

Salary and Benefits

Salary Range: $144,000 - 180,000

Commission Eligible: No

Equity Eligible: Yes

Travel: Yes - Required up to 15% of the time for engineering onsites or off-sites.

Location Requirement: Employment at Alto is limited to individuals residing in the following states: Arizona, Arkansas, California, Colorado, Florida, Kansas, Maryland, Missouri, Nevada, New Jersey, New York, North Carolina, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington (WA), and Wisconsin.

Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. At this time, Alto is unable to sponsor or take over sponsorship of an employment Visa.

Benefits: Full-time employee benefits include: Multiple group medical, dental and vision plans to choose from, 401(k) plan, group life, AD&D, FSA/HSA, employer paid STD/LTD, Take-What-You-Need vacation time, accrued paid sick time, 11 paid holidays (7 for Pharmacy and Care teams), 8 weeks paid parental leave for eligible employees.
Application Deadline: 4/4/2025

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Alto Pharmacy is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at CandidateHelp@alto.com.

Alto Pharmacy considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, and New York City Fair Chance laws. We are an E-Verify participating company.

To learn about Alto's privacy practices including compliance with applicable privacy laws, please click here.